Provider Demographics
NPI:1952055485
Name:MUNDORFF, DANIEL G (MPT)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:G
Last Name:MUNDORFF
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 S BEAVER ST STE 27
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17401-1318
Mailing Address - Country:US
Mailing Address - Phone:610-389-8707
Mailing Address - Fax:
Practice Address - Street 1:31 W HANOVER ST STE 4
Practice Address - Street 2:
Practice Address - City:SPRING GROVE
Practice Address - State:PA
Practice Address - Zip Code:17362-1148
Practice Address - Country:US
Practice Address - Phone:717-225-6671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT012240L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist