Provider Demographics
NPI:1770648412
Name:DANIELS THERAPY SERVICES, INC.
Entity type:Organization
Organization Name:DANIELS THERAPY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:KOLBY
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:MHS, PT
Authorized Official - Phone:650-934-0455
Mailing Address - Street 1:525 SOUTH DR
Mailing Address - Street 2:SUITE211
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4213
Mailing Address - Country:US
Mailing Address - Phone:650-934-0455
Mailing Address - Fax:650-934-0456
Practice Address - Street 1:525 SOUTH DR
Practice Address - Street 2:SUITE211
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4213
Practice Address - Country:US
Practice Address - Phone:650-934-0455
Practice Address - Fax:650-934-0456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT14315261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ30037ZMedicare ID - Type UnspecifiedGROUP ID