Provider Demographics
NPI:1376014530
Name:CAYCE, DANIEL
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:CAYCE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4550 SMACKOVER HWY
Mailing Address - Street 2:
Mailing Address - City:SMACKOIVER
Mailing Address - State:AR
Mailing Address - Zip Code:71762
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4550 SMACKOVER HWY
Practice Address - Street 2:
Practice Address - City:SMACKOIVER
Practice Address - State:AR
Practice Address - Zip Code:71762
Practice Address - Country:US
Practice Address - Phone:870-836-1346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-16
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT3952225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty