Individual
MELISSA DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
6600 VAN AALST BLVD, FORT MOORE, GA 31905-2102
(762) 408-2604
Mailing address
6600 VAN AALST BLVD, FORT MOORE, GA 31905-2102
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1305497
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1305497
STATE LICENSE
AZ
Enumeration date
06/06/2018
Last updated
03/14/2024
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