Provider Demographics
NPI:1073040952
Name:KRAHN, DANIEL CHRISTOPHER (PTA)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:CHRISTOPHER
Last Name:KRAHN
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 WHITEHALL DR APT 106
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33324-6647
Mailing Address - Country:US
Mailing Address - Phone:954-806-2368
Mailing Address - Fax:
Practice Address - Street 1:9211 W BROWARD BLVD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2401
Practice Address - Country:US
Practice Address - Phone:954-806-2368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-22
Last Update Date:2017-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA23095225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant