Provider Demographics
NPI:1821644725
Name:TRANG, DANIEL (LPTA)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:TRANG
Suffix:
Gender:M
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5421 CROWS NEST CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22032-3302
Mailing Address - Country:US
Mailing Address - Phone:703-470-3393
Mailing Address - Fax:
Practice Address - Street 1:6408 GROVEDALE DR STE 102
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-2596
Practice Address - Country:US
Practice Address - Phone:703-884-8490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306605450225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant