Provider Demographics
NPI:1437729829
Name:DAMAGE CONTROL PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:DAMAGE CONTROL PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:R
Authorized Official - Last Name:BRANSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, CDN
Authorized Official - Phone:928-514-1434
Mailing Address - Street 1:1845 S DOBSON RD STE 111
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-5662
Mailing Address - Country:US
Mailing Address - Phone:928-514-1434
Mailing Address - Fax:
Practice Address - Street 1:1845 S DOBSON RD STE 111
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-5662
Practice Address - Country:US
Practice Address - Phone:928-514-1434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-28
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy