Provider Demographics
NPI:1548641731
Name:GODIO, DANIEL PATRICK
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:PATRICK
Last Name:GODIO
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 1:541 BENFOREST DR
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-1731
Mailing Address - Country:US
Mailing Address - Phone:410-533-9142
Mailing Address - Fax:
Practice Address - Street 1:8943 S TRYON ST
Practice Address - Street 2:SUITE K
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-3540
Practice Address - Country:US
Practice Address - Phone:704-588-0885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-12
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP156972251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic