Provider Demographics
NPI:1255745592
Name:WESTPHAL, DANIELLE (DPT)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:WESTPHAL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2472 BECKY LN NE
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:GA
Mailing Address - Zip Code:30319-3450
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1995 N PARK PL SE
Practice Address - Street 2:SUITE 410
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-7801
Practice Address - Country:US
Practice Address - Phone:770-850-0390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-15
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
GAPT011198225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist