Provider Demographics
NPI:1790121366
Name:NIELDS, DANIELLE NICOLE (DPT)
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:NICOLE
Last Name:NIELDS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-3016
Mailing Address - Country:US
Mailing Address - Phone:610-518-9100
Mailing Address - Fax:610-518-0992
Practice Address - Street 1:20 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-3058
Practice Address - Country:US
Practice Address - Phone:610-518-9100
Practice Address - Fax:610-518-0992
Is Sole Proprietor?:No
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT022698225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist