Provider Demographics
NPI:1023494374
Name:DANAT, THOMAS WADE JR (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:WADE
Last Name:DANAT
Suffix:JR
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 1:3350 SOUTHWESTERN BLVD
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1524
Mailing Address - Country:US
Mailing Address - Phone:716-690-2051
Mailing Address - Fax:
Practice Address - Street 1:573 MAZDA TER UPPR
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-6212
Practice Address - Country:US
Practice Address - Phone:716-418-2428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-09
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY62039105225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist