Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PT007010 | GA |
N | 2251S0007X | Physical Therapist - Sports | PT007010 | GA |
Y | 2251X0800X | Physical Therapist - Orthopedic | PT007010 | GA |
NPI | 1003885534 |
---|---|
Provider Name | Donald Houston Daniel |
First Address | Albany, GA 31701-1320 |
Second Address | Albany, GA 31701-1320 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2006 |
Last Update Date | 20/04/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q06655 | (02) | GA |