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NPI Code Detail

MEDICARE: DR. HEATHER MICHELLE DAMAN PT, DPT

MEDICARE:  DR. HEATHER MICHELLE DAMAN  PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT010155GA

General Provider Information

NPI Number : 1063790103
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HEATHER MICHELLE DAMAN PT, DPT
Provider Business Mailing Address
First Line : 135 GOSHEN ROAD EXT
Second Line : SUITE 206
City : RINCON
State : GA
Zip : 31326-5567
Country : US
Telephone Number : 877-826-1509
Fax Number : 912-826-9767
Provider Business Practice Location Address
First Line : 2451 US HIGHWAY 17
Second Line : SUITE B
City : RICHMOND HILL
State : GA
Zip : 31324-3397
Country : US
Telephone Number : 912-459-2230
Fax Number : 912-459-2240
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2011
Last Update Date : 01/24/2014

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Directions to “ DR. HEATHER MICHELLE DAMAN PT, DPT” Practice Location

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