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General NPI Number Information
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NPI Number | 1033693296
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Entity Type | Individual
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Provider Name | DANIELLE SQUIRES PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 09/23/2018
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Last Update Date | 01/17/2024
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Provider Practice Location Address
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Address Line | 175 W MAIN ST
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City | MACUNGIE
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State | PA
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Zip | 18062-1166
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Country | US
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Telephone | 610-966-6773
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Fax |
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Provider Business Mailing Address
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Address Line | 26 N 4TH ST
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City | EASTON
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State | PA
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Zip | 18042-3575
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Country | US
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Telephone | 201-321-4752
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT029203
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA01803600
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License Number State | NJ
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