Provider Demographics
NPI:1669486726
Name:HOWELL, DAMIEN W (MS,PT,OCS)
Entity Type:Individual
Prefix:MR
First Name:DAMIEN
Middle Name:W
Last Name:HOWELL
Suffix:
Gender:M
Credentials:MS,PT,OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 HUGUENOT RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-5600
Mailing Address - Country:US
Mailing Address - Phone:804-594-0403
Mailing Address - Fax:804-594-0319
Practice Address - Street 1:1811 HUGUENOT RD
Practice Address - Street 2:SUITE 103
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-5600
Practice Address - Country:US
Practice Address - Phone:804-594-0403
Practice Address - Fax:804-594-0319
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305000840225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00V479D52Medicare PIN