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General NPI Number Information
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NPI Number | 1598386245
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Entity Type | Organization
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Legal Business Name | DAMON PHYSICAL THERAPY
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Dates
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Enumeration Date | 05/05/2020
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Last Update Date | 05/14/2020
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Provider Practice Location Address
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Address Line | 156 STATE ROUTE 15
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City | LAFAYETTE
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State | NJ
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Zip | 07848-2607
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Country | US
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Telephone | 973-862-6377
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Fax | 973-862-6379
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Provider Business Mailing Address
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Address Line | 1 VAN KIRK PL
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City | SPARTA
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State | NJ
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Zip | 07871-1154
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Country | US
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Telephone | 973-886-4981
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAMON DAURA
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Credential | PT, DPT, OCS,COMT
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Telephone | 973-886-4981
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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