Healthcare Provider Details

I. General information

NPI: 1205486263
Provider Name (Legal Business Name): DANIEL JAMES HASS PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2019
Last Update Date: 09/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 TRANSPORTATION BLVD
GARFIELD HTS OH
44125-5371
US

IV. Provider business mailing address

5555 TRANSPORTATION BLVD
GARFIELD HTS OH
44125-5371
US

V. Phone/Fax

Practice location:
  • Phone: 216-618-1653
  • Fax:
Mailing address:
  • Phone: 216-618-1653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number013804
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number013804
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: