Provider Demographics
NPI:1548790967
Name:LIMPARIS, DANIELLE (PTA)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:LIMPARIS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10819 LAMESA PL
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-7865
Mailing Address - Country:US
Mailing Address - Phone:704-858-5591
Mailing Address - Fax:
Practice Address - Street 1:10506 CLEAR CREEK COMMERCE DR
Practice Address - Street 2:
Practice Address - City:MINT HILL
Practice Address - State:NC
Practice Address - Zip Code:28227-7078
Practice Address - Country:US
Practice Address - Phone:704-858-5591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-18
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA5443225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCA5443OtherNC BOARD OF PHYSICAL THERAPY EXAMINERS