Provider Demographics
NPI:1700302858
Name:HENSLEY, DANIEL S (PA-C, LAT, ATC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:S
Last Name:HENSLEY
Suffix:
Gender:M
Credentials:PA-C, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 BETHLEHEM PIKE
Mailing Address - Street 2:
Mailing Address - City:COLMAR
Mailing Address - State:PA
Mailing Address - Zip Code:18915-9719
Mailing Address - Country:US
Mailing Address - Phone:215-257-3700
Mailing Address - Fax:
Practice Address - Street 1:103 BETHLEHEM PIKE
Practice Address - Street 2:
Practice Address - City:COLMAR
Practice Address - State:PA
Practice Address - Zip Code:18915-9719
Practice Address - Country:US
Practice Address - Phone:215-257-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-21
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARTRT0057022083S0010X
PAMA066612363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2083S0010XAllopathic & Osteopathic PhysiciansPreventive MedicineSports MedicineGroup - Single Specialty