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General NPI Number Information
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NPI Number | 1649360637
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Entity Type | Individual
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Provider Name | TODD J DAME PT
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Gender | Male
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 507 WAKEFIELD DR
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City | CHARLOTTE
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State | NC
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Zip | 28209-3169
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Country | US
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Telephone | 704-285-8207
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Fax | 704-285-8110
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Provider Business Mailing Address
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Address Line | 4210 PORTER PLACE CT
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City | CHARLOTTE
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State | NC
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Zip | 28278-7285
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT009415L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | P23349
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP035513T
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License Number State | SC
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