Provider Demographics
NPI:1043447063
Name:PREUSSER, DANIEL (EDS, MSED, ATC, LAT)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:PREUSSER
Suffix:
Gender:M
Credentials:EDS, MSED, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1971 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24515-0002
Mailing Address - Country:US
Mailing Address - Phone:434-582-2414
Mailing Address - Fax:
Practice Address - Street 1:1104 E LAWN DR
Practice Address - Street 2:APT 302
Practice Address - City:FOREST
Practice Address - State:VA
Practice Address - Zip Code:24551-2983
Practice Address - Country:US
Practice Address - Phone:434-426-0226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-17
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260010472255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer