Provider Demographics
NPI:1437484177
Name:DAMIAN, ALLAN G (PT)
Entity Type:Individual
Prefix:MR
First Name:ALLAN
Middle Name:G
Last Name:DAMIAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E MORRIS BLVD
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-2499
Mailing Address - Country:US
Mailing Address - Phone:423-586-6866
Mailing Address - Fax:423-581-9679
Practice Address - Street 1:901 E MORRIS BLVD
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-2499
Practice Address - Country:US
Practice Address - Phone:423-586-6866
Practice Address - Fax:423-581-9679
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7876225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty