Provider Demographics
NPI:1134406119
Name:LAYGO, DANIELLE ETHIER (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:ETHIER
Last Name:LAYGO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:ALLYSE
Other - Last Name:ETHIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1910 N CHURCH ST
Mailing Address - Street 2:STE D
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-5666
Mailing Address - Country:US
Mailing Address - Phone:336-274-7480
Mailing Address - Fax:336-274-8903
Practice Address - Street 1:1910 N CHURCH ST
Practice Address - Street 2:STE D
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-5666
Practice Address - Country:US
Practice Address - Phone:336-274-7480
Practice Address - Fax:336-274-8903
Is Sole Proprietor?:No
Enumeration Date:2011-11-04
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP13704225100000X
DEJ1-0002777225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist