MEDICARE: DANIEL GORMAN PT

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	10697	NC
2	225100000X	Physical Therapist	21063	FL

General Provider Information

NPI Number	:	1336157932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL GORMAN PT

Provider Business Mailing Address
First Line	:	486 COPPERFIELD BLVD NE
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28025-2404
Country	:	US
Telephone Number	:	704-786-4644
Fax Number	:	704-786-7303

Provider Business Practice Location Address
First Line	:	486 COPPERFIELD BLVD NE
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28025-2404
Country	:	US
Telephone Number	:	704-786-4644
Fax Number	:	704-786-7303

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

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	07/08/2007

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Directions to “ DANIEL GORMAN PT” Practice Location

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