Provider Demographics
NPI:1174077945
Name:BOSWEIN, DANIEL SCOTT (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:SCOTT
Last Name:BOSWEIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5293 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-7007
Mailing Address - Country:US
Mailing Address - Phone:559-221-1474
Mailing Address - Fax:559-221-0327
Practice Address - Street 1:5293 N 1ST ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7007
Practice Address - Country:US
Practice Address - Phone:559-221-1474
Practice Address - Fax:559-221-0327
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-10
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30981111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor