Provider Demographics
NPI:1093758070
Name:CONRAD, DANIELLE MARIE (DPT)
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:MARIE
Last Name:CONRAD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:MARIE
Other - Last Name:CONRAD-REED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-541-5492
Mailing Address - Fax:
Practice Address - Street 1:6006 MAHONING AVE STE G
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2239
Practice Address - Country:US
Practice Address - Phone:330-755-3000
Practice Address - Fax:234-226-4201
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT018287225100000X
MD21534225100000X
OHPT018772225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist