Healthcare Provider Details

I. General information

NPI: 1205803780
Provider Name (Legal Business Name): DARYL G DAMRON PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2006
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 S BALLENGER HWY
FLINT MI
48532-3638
US

IV. Provider business mailing address

401 S BALLENGER HWY
FLINT MI
48532-3638
US

V. Phone/Fax

Practice location:
  • Phone: 810-342-5700
  • Fax:
Mailing address:
  • Phone: 810-342-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301006527
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601003439
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: