Provider Demographics
NPI:1265800072
Name:POTTS, DANIELLE CHRISTINE (DPT)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:CHRISTINE
Last Name:POTTS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:CHRISTINE
Other - Last Name:WISSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 536826
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15253-6800
Mailing Address - Country:US
Mailing Address - Phone:616-356-5000
Mailing Address - Fax:616-356-5001
Practice Address - Street 1:2158 NORTHGATE PARK LN STE 200
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37415-6911
Practice Address - Country:US
Practice Address - Phone:423-254-5461
Practice Address - Fax:800-385-7439
Is Sole Proprietor?:No
Enumeration Date:2015-09-10
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10489225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist