Individual
GARY DANIELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC/R
Contact information
Practice address
4901 E UNIVERSITY BLVD, ODESSA, TX 79762-8122
(432) 552-2679
Mailing address
4001 FAUDREE RD, APT. D203, ODESSA, TX 79765-8620
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
AT6549
TX
Other
Enumeration date
02/03/2016
Last updated
02/03/2016
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