Healthcare Provider Details

I. General information

NPI: 1992814511
Provider Name (Legal Business Name): FRANCINE M. D'AMICO P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FRANCINE M. D'AMICO P.T.

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 03/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12357 HAYNES ST.
CLINTON LA
70722-8508
US

IV. Provider business mailing address

12357 HAYNES ST.
CLINTON LA
70722-8508
US

V. Phone/Fax

Practice location:
  • Phone: 225-683-1125
  • Fax: 225-683-1127
Mailing address:
  • Phone: 225-683-1125
  • Fax: 225-683-1127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number01239
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: