| Doctor Name: | MRS. DANIELLE LATRICIA GOMER |
| NPI Number: | 1083884613 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PTA |
| License Number: | J2-0000642 |
| Business Practice Address: | 606 Cannon Street Chestertown, MD - 21620 |
| Business Phone Number: | 4108102957 |
| Business Fax Number: | |
| Mailing Address: | 606 Cannon Street, CHESTERTOWN |
| State: | MD |
| Postal Code: | 21620 |
| Phone Number: | 4108102957 |
| Fax Number: | |
| NPI Enumeration Date: | 03/11/2008 |
| NPI Last Update Date: | 03/11/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | J2-0000642 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | DE |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |