Healthcare Provider Details

I. General information

NPI: 1265328082
Provider Name (Legal Business Name): DANIEL LEONARD KOTIK PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 07/11/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5142 ROUTE 30
GREENSBURG PA
15601-7657
US

IV. Provider business mailing address

212 LONGVIEW DR
IRWIN PA
15642-4720
US

V. Phone/Fax

Practice location:
  • Phone: 724-830-8750
  • Fax:
Mailing address:
  • Phone: 724-396-1081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT033392
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: