Provider Demographics
NPI:1770008526
Name:BROWN, DANIEL RYAN (ATC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:RYAN
Last Name:BROWN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 MCBRY DR
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-4407
Mailing Address - Country:US
Mailing Address - Phone:302-465-2756
Mailing Address - Fax:
Practice Address - Street 1:402 E COLLEGE ST # 570
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:VA
Practice Address - Zip Code:22812-1511
Practice Address - Country:US
Practice Address - Phone:302-465-2756
Practice Address - Fax:302-465-2756
Is Sole Proprietor?:No
Enumeration Date:2017-08-13
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
VA20000345692255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer