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General NPI Number Information
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NPI Number | 1578310843
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Entity Type | Individual
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Provider Name | DANIEL HARRELL PT
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Gender | Male
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Dates
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Enumeration Date | 05/03/2024
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Last Update Date | 05/03/2024
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Provider Practice Location Address
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Address Line | 2401 LEE HWY N
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City | PULASKI
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State | VA
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Zip | 24301-2325
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Country | US
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Telephone | 540-980-3111
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Fax |
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Provider Business Mailing Address
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Address Line | 903 CHESLEY ST
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City | RADFORD
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State | VA
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Zip | 24141-2736
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Country | US
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Telephone | 540-320-1699
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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 | 2305210765
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License Number State | VA
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