Provider Demographics
NPI:1093377236
Name:ESPINO, DANIELA M (DPT, PT)
Entity Type:Individual
Prefix:
First Name:DANIELA
Middle Name:M
Last Name:ESPINO
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 DEKALB INDUSTRIAL WAY STE 103
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-1756
Mailing Address - Country:US
Mailing Address - Phone:404-296-8511
Mailing Address - Fax:404-296-8514
Practice Address - Street 1:575 DEKALB INDUSTRIAL WAY STE 103
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1756
Practice Address - Country:US
Practice Address - Phone:404-296-8511
Practice Address - Fax:404-296-8514
Is Sole Proprietor?:No
Enumeration Date:2019-07-08
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT61228011225100000X
GAPT014083225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist