Provider Demographics
NPI:1538469648
Name:MOORE, DANIELLE MARIE (PT)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:MARIE
Last Name:MOORE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5473 ASHERBRAND LN
Mailing Address - Street 2:APT B
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-5090
Mailing Address - Country:US
Mailing Address - Phone:740-815-7635
Mailing Address - Fax:
Practice Address - Street 1:460 W CENTRAL AVE
Practice Address - Street 2:SUITE B
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-1435
Practice Address - Country:US
Practice Address - Phone:740-369-5633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT0130752251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic