Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 1271099 | TX |
NPI | 1033578406 |
---|---|
Provider Name | Erika Daniele |
First Address | Cedar Park, TX 78613-5722 |
Second Address | Austin, TX 78705-1121 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2016 |
Last Update Date | 15/02/2016 |