Provider Demographics
NPI:1154460723
Name:WHITTEN, DANLADI (PT)
Entity Type:Individual
Prefix:MR
First Name:DANLADI
Middle Name:
Last Name:WHITTEN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2630 MONROE ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-2918
Mailing Address - Country:US
Mailing Address - Phone:202-203-8056
Mailing Address - Fax:
Practice Address - Street 1:901 6TH ST SW STE PTC
Practice Address - Street 2:FINTESS CENTER
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20024-3850
Practice Address - Country:US
Practice Address - Phone:202-646-0100
Practice Address - Fax:202-646-0766
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT870222225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCG00725Medicare UPIN