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General NPI Number Information
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NPI Number | 1457030124
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Entity Type | Organization
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Legal Business Name | I AM DANIE LLC
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Dates
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Enumeration Date | 07/11/2023
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Last Update Date | 07/11/2023
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Provider Practice Location Address
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Address Line | 1745 PEACHTREE ST NE STE F
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City | ATLANTA
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State | GA
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Zip | 30309-2463
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Country | US
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Telephone | 404-919-3263
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Fax |
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Provider Business Mailing Address
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Address Line | 230 18TH ST NW UNIT 11420
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City | ATLANTA
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State | GA
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Zip | 30363-1183
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Country | US
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Telephone | 404-919-3263
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANIELLE WILKS
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Credential |
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Telephone | 678-595-5882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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