Healthcare Provider Details
I. General information
NPI: 1083011225
Provider Name (Legal Business Name): DANIEL GEORGE MULLER PT, DPT, OCS, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/03/2014
Last Update Date: 12/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 FREEDOM WAY
AUGUSTA GA
30904-6258
US
IV. Provider business mailing address
1 FREEDOM WAY
AUGUSTA GA
30904-6258
US
V. Phone/Fax
- Phone: 706-733-0188
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251X0800X |
| Taxonomy | Orthopedic Physical Therapist |
| License Number | PT010064 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: