MEDICARE: DANIELLE KIRKPATRICK 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	52013	AL

General Provider Information

NPI Number	:	1922484252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE KIRKPATRICK PT

Provider Business Mailing Address
First Line	:	5923 MONTICELLO DR
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36117-1940
Country	:	US
Telephone Number	:	334-356-6453
Fax Number	:

Provider Business Practice Location Address
First Line	:	5923 MONTICELLO DR
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36117-1940
Country	:	US
Telephone Number	:	334-356-6453
Fax Number	:

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

Provider Enumeration Date	:	08/10/2015
Last Update Date	:	08/10/2015

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