Provider Demographics
NPI:1609107168
Name:STONER, DANIELIA MARIE (PTA)
Entity Type:Individual
Prefix:
First Name:DANIELIA
Middle Name:MARIE
Last Name:STONER
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 1:9930 W COUNTY ROAD 75 S
Mailing Address - Street 2:
Mailing Address - City:FRENCH LICK
Mailing Address - State:IN
Mailing Address - Zip Code:47432-9516
Mailing Address - Country:US
Mailing Address - Phone:812-936-3020
Mailing Address - Fax:
Practice Address - Street 1:457 S STATE ROAD 145
Practice Address - Street 2:
Practice Address - City:FRENCH LICK
Practice Address - State:IN
Practice Address - Zip Code:47432-1036
Practice Address - Country:US
Practice Address - Phone:812-936-9991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-22
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06002826A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant