Provider Demographics
NPI:1609480920
Name:DANOS, LANCE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:LANCE
Middle Name:
Last Name:DANOS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4615 US-80
Mailing Address - Street 2:#9
Mailing Address - City:HAUGHTON
Mailing Address - State:LA
Mailing Address - Zip Code:71037
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4615 US-80
Practice Address - Street 2:#9
Practice Address - City:HAUGHTON
Practice Address - State:LA
Practice Address - Zip Code:71037
Practice Address - Country:US
Practice Address - Phone:318-615-3003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09964225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty