Provider Demographics
NPI:1598386245
Name:DAMON PHYSICAL THERAPY
Entity Type:Organization
Organization Name:DAMON PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:DAURA
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, OCS,COMT
Authorized Official - Phone:973-886-4981
Mailing Address - Street 1:1 VAN KIRK PL
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-1154
Mailing Address - Country:US
Mailing Address - Phone:973-886-4981
Mailing Address - Fax:
Practice Address - Street 1:156 STATE ROUTE 15
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:NJ
Practice Address - Zip Code:07848-2607
Practice Address - Country:US
Practice Address - Phone:973-862-6377
Practice Address - Fax:973-862-6379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-05
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty