Provider Demographics
NPI:1164812012
Name:BARNES, DANIELLE SAMON (PT, DPT)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:SAMON
Last Name:BARNES
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 COLEY RD
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-9042
Mailing Address - Country:US
Mailing Address - Phone:919-440-9383
Mailing Address - Fax:
Practice Address - Street 1:148 COLEY RD
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-9042
Practice Address - Country:US
Practice Address - Phone:919-440-9383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-30
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14703225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist