Most Relevant Information
Provider Data
| NPI Number: | 1003595778 |
| Provider Name: | DANIELLE WILKS |
| Entity Type: | Individual |
| Taxonomy Code: | 335E00000X |
| Specialty: | Prosthetic/Orthotic Supplier |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/11/2023 |
| Last Updated: | 07/11/2023 |
Provider Practice Location
1745 PEACHTREE ST NE STE F
ATLANTA
GA
303092463
Practice Location Phone/Fax
| Phone: | 4049193263 |
| Fax: |
Provider Mailing Location
230 18TH ST NW UNIT 11420
ATLANTA
GA
303631183
Provider Mailing Phone/Fax
| Phone: | 4049193263 |
| Fax: |