Provider Demographics
NPI:1487932703
Name:PARADIS, DANIEL STEVEN (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:STEVEN
Last Name:PARADIS
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 1:1716 S MARION RD
Mailing Address - Street 2:STE. 3
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-3643
Mailing Address - Country:US
Mailing Address - Phone:605-362-8084
Mailing Address - Fax:605-323-1175
Practice Address - Street 1:1716 S MARION RD
Practice Address - Street 2:STE. 3
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-3643
Practice Address - Country:US
Practice Address - Phone:605-362-8084
Practice Address - Fax:605-323-1175
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1197111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor