Provider Demographics
NPI:1982806360
Name:DELL, DANIELLE KRISTY
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:KRISTY
Last Name:DELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400A LEAFMORE RD SW
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-3819
Mailing Address - Country:US
Mailing Address - Phone:706-252-1263
Mailing Address - Fax:
Practice Address - Street 1:400A LEAFMORE RD SW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-3819
Practice Address - Country:US
Practice Address - Phone:706-252-1263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT0073192251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics