Provider Demographics
NPI:1164659538
Name:DANOS, JAMIE (PTA)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:DANOS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 E 114TH ST
Mailing Address - Street 2:
Mailing Address - City:GALLIANO
Mailing Address - State:LA
Mailing Address - Zip Code:70354-4122
Mailing Address - Country:US
Mailing Address - Phone:985-693-8677
Mailing Address - Fax:985-693-8126
Practice Address - Street 1:146 EAST 28TH ST
Practice Address - Street 2:
Practice Address - City:CUT OFF
Practice Address - State:LA
Practice Address - Zip Code:70345
Practice Address - Country:US
Practice Address - Phone:985-693-8677
Practice Address - Fax:985-693-8126
Is Sole Proprietor?:No
Enumeration Date:2009-06-12
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAA7146225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant