Basic Information
Provider Information
NPI: 1003298621
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HONNETTE
FirstName: DANIELLE
MiddleName: R
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 415 36TH ST STE 100
Address2:  
City: PARKERSBURG
State: WV
PostalCode: 261011005
CountryCode: US
TelephoneNumber: 3049173660
FaxNumber: 3049173674
Practice Location
Address1: 1720 SE 16TH AVE STE 302
Address2:  
City: OCALA
State: FL
PostalCode: 34471
CountryCode: US
TelephoneNumber: 3525120825
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/19/2015
LastUpdateDate: 01/14/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT34307FLY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X05011744AINN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X9965MNN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


Home