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Individual

DR. GREGORY ROBERT DANIELS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
2257 S 108TH ST, WEST ALLIS, WI 53227-1107
(141) 432-7711
(141) 432-7671
Mailing address
2257 S 108TH ST, WEST ALLIS, WI 53227-1107
(141) 432-7711
(141) 432-7671

Taxonomy

Speciality
Code
Description
License number
State
111NI0013X
Independent Medical Examiner Chiropractor
Primary
1931
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1931
STATE LICENSE
WI
05
38784900
WI
Enumeration date
04/20/2007
Last updated
07/08/2007
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