Provider Demographics
NPI:1356868590
Name:ROOP, DANIEL (OTR/L)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:ROOP
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8323 BAY GARDEN LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37938-4595
Mailing Address - Country:US
Mailing Address - Phone:423-489-0884
Mailing Address - Fax:
Practice Address - Street 1:1006 OLD KNOXVILLE RD
Practice Address - Street 2:
Practice Address - City:TAZEWELL
Practice Address - State:TN
Practice Address - Zip Code:37879-4138
Practice Address - Country:US
Practice Address - Phone:423-626-2405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2017-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2487225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist