Provider Demographics
NPI:1073659488
Name:CROSS, DANIEL BRENT (PT)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:BRENT
Last Name:CROSS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:330 THOMAS MORE PKWY STE 102
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-3421
Mailing Address - Country:US
Mailing Address - Phone:859-426-5666
Mailing Address - Fax:859-426-5665
Practice Address - Street 1:330 THOMAS MORE PKWY STE 102
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3421
Practice Address - Country:US
Practice Address - Phone:859-426-5666
Practice Address - Fax:859-426-5665
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY028312251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics