Basic Information
| Provider Information | |||||||||
| NPI: | 1235785940 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HASSELL | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | SCOTT | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 349 E LEXINGTON RD | ||||||||
| Address2: | |||||||||
| City: | LITITZ | ||||||||
| State: | PA | ||||||||
| PostalCode: | 175438971 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7173715357 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1011 W PENN AVE | ||||||||
| Address2: | |||||||||
| City: | ROBESONIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 195519550 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6105892263 | ||||||||
| FaxNumber: | 6105892232 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2019 | ||||||||
| LastUpdateDate: | 08/18/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 027671 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.