Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 5841 | OR |
NPI | 1003325531 |
---|---|
Provider Name | Daniel L Hubbell |
First Address | Fairview, OR 97024-3867 |
Second Address | Fairview, OR 97024 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2017 |
Last Update Date | 03/09/2019 |