Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225200000X | Physical Therapy Assistant | 4530 | NC |
Y | 225200000X | Physical Therapy Assistant | PTA 001639 | WV |
NPI | 1003114117 |
---|---|
Provider Name | Sherri Daniel |
First Address | Beckley, WV 25801-2506 |
Second Address | South Daytona, FL 32119-1712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2011 |
Last Update Date | 14/03/2011 |