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General NPI Number Information
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NPI Number | 1619305489
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Entity Type | Individual
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Provider Name | DANIELLE ADLER KROOT PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 10/14/2013
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Last Update Date | 01/31/2019
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Provider Practice Location Address
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Address Line | 49 DARTMOUTH ST
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City | PORTLAND
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State | ME
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Zip | 04101
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Country | US
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Telephone | 207-835-1513
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Fax |
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Provider Business Mailing Address
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Address Line | 265 STEVENS AVE
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City | PORTLAND
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State | ME
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Zip | 04103-2627
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Country | US
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Telephone | 631-375-5684
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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 | 20630
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT5156
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License Number State | ME
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