Basic Information
Provider Information
NPI: 1619256211
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAYS
FirstName: DANAE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2695 S DEFRAME CIR
Address2:  
City: LAKEWOOD
State: CO
PostalCode: 802284740
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 5535 S WILLIAMSON BLVD
Address2: 774
City: PORT ORANGE
State: FL
PostalCode: 321288311
CountryCode: US
TelephoneNumber: 8003307711
FaxNumber: 8664262811
Other Information
ProviderEnumerationDate: 08/12/2011
LastUpdateDate: 08/12/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPTL-8793COY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


Home