Provider Demographics
NPI:1558586644
Name:HIGGINS, DANIEL
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:HIGGINS
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 1:127 NEBRASKA AVE
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-8143
Mailing Address - Country:US
Mailing Address - Phone:865-483-7091
Mailing Address - Fax:
Practice Address - Street 1:USS HARRY S TRUMAN
Practice Address - Street 2:CVN 75
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09524-0080
Practice Address - Country:US
Practice Address - Phone:757-443-7882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 22359225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist