Provider Demographics
NPI:1396103883
Name:DANUSER, DANIEL
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:DANUSER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 1ST ST NW
Mailing Address - Street 2:
Mailing Address - City:ULEN
Mailing Address - State:MN
Mailing Address - Zip Code:56585-4010
Mailing Address - Country:US
Mailing Address - Phone:218-596-8860
Mailing Address - Fax:218-596-8861
Practice Address - Street 1:317 1ST ST NW
Practice Address - Street 2:
Practice Address - City:ULEN
Practice Address - State:MN
Practice Address - Zip Code:56585-4010
Practice Address - Country:US
Practice Address - Phone:218-596-8860
Practice Address - Fax:218-596-8861
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-29
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNA1408225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant