Provider Demographics
NPI:1659308633
Name:OGLE, DAMON (LMT)
Entity Type:Individual
Prefix:
First Name:DAMON
Middle Name:
Last Name:OGLE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LA COLLEGE P.O. BOX 505
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71359-0505
Mailing Address - Country:US
Mailing Address - Phone:318-487-7174
Mailing Address - Fax:
Practice Address - Street 1:LA COLLEGE 1140 COLLEGE DR.
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71359-0505
Practice Address - Country:US
Practice Address - Phone:318-487-7174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist