Provider Demographics
NPI:1356733133
Name:KILPS, DANIELLE (ATC/L)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:KILPS
Suffix:
Gender:F
Credentials:ATC/L
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:HOAG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC/L
Mailing Address - Street 1:1041 HILL ST
Mailing Address - Street 2:
Mailing Address - City:WISCONSIN RAPIDS
Mailing Address - State:WI
Mailing Address - Zip Code:54494-5221
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1041 HILL ST
Practice Address - Street 2:
Practice Address - City:WISCONSIN RAPIDS
Practice Address - State:WI
Practice Address - Zip Code:54494-5221
Practice Address - Country:US
Practice Address - Phone:608-403-6744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-03
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0960038302255A2300X
WI1888-392255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer