Individual
MRS. DANIELLE NICOLE MODAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
113 W CHIPOLA AVE STE 219, DELAND, FL 32720-7512
(386) 873-7590
(866) 237-9650
Mailing address
PO BOX 1975, ROME, GA 30162-1975
(386) 873-7590
(866) 237-9650
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT30674
FL
Other
Enumeration date
12/22/2015
Last updated
12/22/2015
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