Provider Demographics
NPI:1467819581
Name:DANIELS, PHUONG THI NGOC (DO, DPT)
Entity Type:Individual
Prefix:DR
First Name:PHUONG
Middle Name:THI NGOC
Last Name:DANIELS
Suffix:
Gender:F
Credentials:DO, DPT
Other - Prefix:
Other - First Name:PHUONG
Other - Middle Name:THI NGOC
Other - Last Name:BUI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:603 BEAMAN ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328-2650
Mailing Address - Country:US
Mailing Address - Phone:910-596-5409
Mailing Address - Fax:
Practice Address - Street 1:603 BEAMAN ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-2650
Practice Address - Country:US
Practice Address - Phone:910-596-5409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-20
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT022095225100000X
NCRTL23-0491390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist