Provider Demographics
NPI:1790395366
Name:PECK, DANIELLE SKYE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:SKYE
Last Name:PECK
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:SKYE
Other - Last Name:CRONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:880 E BOUNDARY AVE
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-2865
Mailing Address - Country:US
Mailing Address - Phone:717-465-8628
Mailing Address - Fax:
Practice Address - Street 1:1520 HARRISBURG PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2632
Practice Address - Country:US
Practice Address - Phone:717-735-2686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE010982208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation