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General NPI Number Information
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NPI Number | 1477733616
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Entity Type | Individual
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Provider Name | DANIELLE DENEEN THOMAS EMERGENCY MED. TECH.
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Gender | Female
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Dates
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Enumeration Date | 11/05/2007
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Last Update Date | 11/05/2007
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Provider Practice Location Address
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Address Line | 3420 MAIN ST
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City | WEIRTON
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State | WV
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Zip | 26062-4557
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Country | US
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Telephone | 412-519-4566
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Fax |
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Provider Business Mailing Address
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Address Line | 174 LEEPER LN
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City | GEORGETOWN
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State | PA
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Zip | 15043-1098
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Country | US
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Telephone | 412-519-4566
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 2007-2290
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License Number State | WV
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