Provider Demographics
NPI:1225071202
Name:KRAUSHAAR, DANIEL JR (PT, CSCS)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:JR
Last Name:KRAUSHAAR
Suffix:
Gender:M
Credentials:PT, CSCS
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Other - Middle Name:
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Mailing Address - Street 1:111 N MARIETTA PKWY NE
Mailing Address - Street 2:A112
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1478
Mailing Address - Country:US
Mailing Address - Phone:706-536-7851
Mailing Address - Fax:
Practice Address - Street 1:59 EXECUTIVE PARK SOUTH NE
Practice Address - Street 2:SUITE 1100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-2208
Practice Address - Country:US
Practice Address - Phone:404-778-6330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT008105225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAQ01920Medicare UPIN