Provider Demographics
NPI:1720144462
Name:MCDANIEL, JOSEPH (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:MCDANIEL
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 S PAINTER AVE STE C
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:AL
Mailing Address - Zip Code:36360-1802
Mailing Address - Country:US
Mailing Address - Phone:334-774-0370
Mailing Address - Fax:334-774-0732
Practice Address - Street 1:123 S PAINTER AVE STE C
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AL
Practice Address - Zip Code:36360-1802
Practice Address - Country:US
Practice Address - Phone:334-774-0370
Practice Address - Fax:334-774-0732
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH3463225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51534590OtherBCBS OF AL