Provider Demographics
NPI:1710605191
Name:KAMMIRE, DANIEL (PT, DPT, MS)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:KAMMIRE
Suffix:
Gender:M
Credentials:PT, DPT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 JOHNNIE DODDS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-6130
Mailing Address - Country:US
Mailing Address - Phone:843-606-1490
Mailing Address - Fax:
Practice Address - Street 1:900 JOHNNIE DODDS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-6130
Practice Address - Country:US
Practice Address - Phone:843-606-1490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-22
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11320225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist