Provider Demographics
NPI:1437355914
Name:PARKER, DANILLE (PT)
Entity Type:Individual
Prefix:MRS
First Name:DANILLE
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DANILLE
Other - Middle Name:
Other - Last Name:DIAZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:7731 GREENHAVEN TER
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:WI
Mailing Address - Zip Code:53185-1883
Mailing Address - Country:US
Mailing Address - Phone:414-839-4460
Mailing Address - Fax:
Practice Address - Street 1:7 CLYDE RD
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-5049
Practice Address - Country:US
Practice Address - Phone:732-873-5133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6080-0242251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics