Provider Demographics
NPI:1871221499
Name:DANSE, WILLIAM (PT, DPT)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:DANSE
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 BROADWAY STE 2
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-1803
Mailing Address - Country:US
Mailing Address - Phone:858-755-5200
Mailing Address - Fax:619-739-4701
Practice Address - Street 1:1016 BROADWAY STE 2
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-1803
Practice Address - Country:US
Practice Address - Phone:858-755-5200
Practice Address - Fax:619-739-4701
Is Sole Proprietor?:No
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA302451225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist