Individual
DOUGLAS MARION MCDANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
5932 85TH ST, PLEASANT PRAIRIE, WI 53158
(262) 914-5674
Mailing address
5932 85TH ST, PLEASANT PRAIRIE, WI 53158-3100
(262) 914-5674
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1134-19
WI
Other
Enumeration date
12/20/2016
Last updated
12/21/2016
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