Provider Demographics
NPI:1790099158
Name:MIDKIFF, DANIEL DAVID (DPT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:DAVID
Last Name:MIDKIFF
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 HUNGARY SPRING RD
Mailing Address - Street 2:UNIT D
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23228-2428
Mailing Address - Country:US
Mailing Address - Phone:804-756-8490
Mailing Address - Fax:
Practice Address - Street 1:3001 HUNGARY SPRING RD
Practice Address - Street 2:UNIT D
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23228-2428
Practice Address - Country:US
Practice Address - Phone:804-756-8490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-27
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305206670225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist