Individual
DR. DANIEL L ROACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
704 N STATE HIGHWAY 47, WARRENTON, MO 63383-1108
(636) 400-3213
Mailing address
704 N STATE HIGHWAY 47, WARRENTON, MO 63383-1108
(636) 400-3213
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2010033249
MO
225000000X
Orthotic Fitter
—
MO
332B00000X
Durable Medical Equipment & Medical Supplies
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
830068901
—
MO
Enumeration date
09/28/2010
Last updated
07/29/2022
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