Provider Demographics
NPI:1164551149
Name:OLORUNFEMI, DAMITA R (PTA)
Entity Type:Individual
Prefix:
First Name:DAMITA
Middle Name:R
Last Name:OLORUNFEMI
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7380 SW 60TH AVE
Mailing Address - Street 2:SUITE3
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-6407
Mailing Address - Country:US
Mailing Address - Phone:352-840-0004
Mailing Address - Fax:352-873-2631
Practice Address - Street 1:7380 SW 60TH AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-6407
Practice Address - Country:US
Practice Address - Phone:352-840-0004
Practice Address - Fax:352-873-2631
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2012-09-06
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant