Provider Demographics
NPI:1447277017
Name:ACKER, DANIEL E (OTR)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:E
Last Name:ACKER
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 PEACHTREE RD NE
Mailing Address - Street 2:SUITE 425
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1848
Mailing Address - Country:US
Mailing Address - Phone:404-352-3522
Mailing Address - Fax:404-601-1235
Practice Address - Street 1:1819 PEACHTREE RD NE
Practice Address - Street 2:SUITE 425
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1848
Practice Address - Country:US
Practice Address - Phone:404-352-3522
Practice Address - Fax:404-601-1235
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT001875225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAQ12827Medicare UPIN
GA65BBCLVMedicare ID - Type Unspecified