MEDICARE: DR. MATTHEW RANDALL DAMPF 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
1	2251X0800X	Orthopedic Physical Therapist	2025020894	MO

General Provider Information

NPI Number	:	1720973092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW RANDALL DAMPF PT, DPT

Provider Business Mailing Address
First Line	:	4112 GREENBRIER DR
Second Line	:
City	:	JEFFERSON CITY
State	:	MO
Zip	:	65109-8718
Country	:	US
Telephone Number	:	573-690-6136
Fax Number	:

Provider Business Practice Location Address
First Line	:	2701 W EDGEWOOD DR STE 105
Second Line	:
City	:	JEFFERSON CITY
State	:	MO
Zip	:	65109-5890
Country	:	US
Telephone Number	:	573-761-5130
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2025
Last Update Date	:	06/09/2025

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