Provider Demographics
NPI:1952040107
Name:SMITH, DANIEL BRIAN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:BRIAN
Last Name:SMITH
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 MILLWATER XING
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-3252
Mailing Address - Country:US
Mailing Address - Phone:470-774-5291
Mailing Address - Fax:
Practice Address - Street 1:857 COLLIER RD NW STE 1
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-2544
Practice Address - Country:US
Practice Address - Phone:404-419-7760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-03
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT0159582251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic