Doctor Name: | MRS. DANIELLE NICOLE MODAK |
NPI Number: | 1336504190 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPT |
License Number: | PT30674 |
Business Practice Address: | 113 W Chipola Ave Ste 219 Deland, FL - 327207512 |
Business Phone Number: | 3868737590 |
Business Fax Number: | 8662379650 |
Mailing Address: | Po Box 1975, ROME |
State: | GA |
Postal Code: | 301621975 |
Phone Number: | 3868737590 |
Fax Number: | 8662379650 |
NPI Enumeration Date: | 12/22/2015 |
NPI Last Update Date: | 12/22/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT30674 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |