Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 1150 | MS |
NPI | 1003142217 |
---|---|
Provider Name | Dr. Daniel Brandon Herrington |
First Address | Laurel, MS 39440-2652 |
Second Address | Laurel, MS 39440-2652 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2009 |
Last Update Date | 22/10/2009 |