Provider Demographics
NPI:1104231224
Name:MOORAD, DANIELLE JOYCE ROHRBACHER (PT, DPT)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:JOYCE ROHRBACHER
Last Name:MOORAD
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:JOYCE ROHRBACHER
Other - Last Name:WETTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:225 E MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:GRANTSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84029-9031
Mailing Address - Country:US
Mailing Address - Phone:435-244-2422
Mailing Address - Fax:435-274-3047
Practice Address - Street 1:225 E MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:GRANTSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84029-9031
Practice Address - Country:US
Practice Address - Phone:435-244-2422
Practice Address - Fax:435-274-3047
Is Sole Proprietor?:No
Enumeration Date:2014-06-26
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2999225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist