Provider Demographics
NPI:1225140833
Name:RANUCCI, DANIEL (PT)
Entity Type:Individual
Prefix:PROF
First Name:DANIEL
Middle Name:
Last Name:RANUCCI
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 1:888 S CRAYCROFT RD
Mailing Address - Street 2:SUITE140
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-7118
Mailing Address - Country:US
Mailing Address - Phone:520-747-5557
Mailing Address - Fax:520-747-1633
Practice Address - Street 1:888 S CRAYCROFT RD
Practice Address - Street 2:SUITE140
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-7118
Practice Address - Country:US
Practice Address - Phone:520-747-5557
Practice Address - Fax:520-747-1633
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2296225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ110594Medicaid
AZ86-0592518OtherTAX ID