Provider Demographics
NPI:1740877208
Name:MONROE, PATRICK DANIEL (DPT)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:DANIEL
Last Name:MONROE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 BROOK AVE
Mailing Address - Street 2:
Mailing Address - City:SECANE
Mailing Address - State:PA
Mailing Address - Zip Code:19018-3612
Mailing Address - Country:US
Mailing Address - Phone:610-618-9167
Mailing Address - Fax:
Practice Address - Street 1:914 JUSTISON ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-5150
Practice Address - Country:US
Practice Address - Phone:302-351-0302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT028928225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty