Provider Demographics
NPI:1336227479
Name:NAVARRO, DANIEL A (PT, MPT, OCS, MTC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:A
Last Name:NAVARRO
Suffix:
Gender:M
Credentials:PT, MPT, OCS, MTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2076 OLD GEORGIAN TER NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-1075
Mailing Address - Country:US
Mailing Address - Phone:404-992-5174
Mailing Address - Fax:404-351-3977
Practice Address - Street 1:857 COLLIER RD NW
Practice Address - Street 2:SUITE 1
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-2532
Practice Address - Country:US
Practice Address - Phone:404-419-7760
Practice Address - Fax:404-351-3977
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA006985225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGA006985OtherSTATE LISC. NUMBER