Provider Demographics
NPI:1184303430
Name:NOWLIN, DANIELLE (PT, DPT)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:NOWLIN
Suffix:
Gender:F
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 1:112 LILLY GRACE LN
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-7379
Mailing Address - Country:US
Mailing Address - Phone:843-300-2448
Mailing Address - Fax:
Practice Address - Street 1:507 HOSPITAL WAY
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:WA
Practice Address - Zip Code:98812-0019
Practice Address - Country:US
Practice Address - Phone:509-689-2517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-13
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VACP031594T225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist