MEDICARE: MRS. DANIELLE ETHIER LAYGO PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	P13704	NC
2	225100000X	Physical Therapist	J1-0002777	DE

General Provider Information

NPI Number	:	1134406119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DANIELLE ETHIER LAYGO PT, DPT

Provider Business Mailing Address
First Line	:	105 S MANGUM ST STE 102
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27701-3614
Country	:	US
Telephone Number	:	336-540-4007
Fax Number	:

Provider Business Practice Location Address
First Line	:	2998 ALAMANCE RD STE B
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27407-7454
Country	:	US
Telephone Number	:	919-473-6033
Fax Number	:	888-671-1333

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2011
Last Update Date	:	05/19/2026

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