Provider Demographics
NPI:1770889958
Name:HINDERLITER, DANIEL EARL
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:EARL
Last Name:HINDERLITER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 BYRD RD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:TN
Mailing Address - Zip Code:37058-3733
Mailing Address - Country:US
Mailing Address - Phone:931-627-0118
Mailing Address - Fax:
Practice Address - Street 1:105 BYRD RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:TN
Practice Address - Zip Code:37058-3733
Practice Address - Country:US
Practice Address - Phone:931-627-0118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-04
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications