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NPI Code Detail

MEDICARE: JEFFREY DANIELS PT, DPT

MEDICARE: JEFFREY DANIELS 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
1225100000XPhysical TherapistCP004290TMS
2225100000XPhysical Therapist11530TN
3225100000XPhysical TherapistCP026181TMS

General Provider Information

NPI Number : 1346699436
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY DANIELS PT, DPT
Provider Business Mailing Address
First Line : 1200 CORPORATE DR STE 400
Second Line :
City : HOOVER
State : AL
Zip : 35242-5424
Country : US
Telephone Number : 423-777-6236
Fax Number :
Provider Business Practice Location Address
First Line : 8110 CAMP CREEK RD STE 106
Second Line :
City : OLIVE BRANCH
State : MS
Zip : 38654-1622
Country : US
Telephone Number : 662-893-1933
Fax Number : 662-893-1934
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2016
Last Update Date : 11/29/2023

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Directions to “ JEFFREY DANIELS PT, DPT” Practice Location

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