Individual
MS. DANIELLE RENE BOOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
733 VOLVO PKWY, SUITE 100, CHESAPEAKE, VA 23320-1609
(757) 321-3383
(757) 321-3332
Mailing address
230 CLEARFIELD AVE, SUITE 124, VIRGINIA BEACH, VA 23462-1832
(757) 321-3383
(757) 321-3332
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305205988
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C05501
MEDICARE GROUP
VA
Enumeration date
06/26/2009
Last updated
09/08/2022
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