Provider Demographics
NPI:1982654802
Name:DAMATO, KAMI H (PT)
Entity Type:Individual
Prefix:MS
First Name:KAMI
Middle Name:H
Last Name:DAMATO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:KAMI
Other - Middle Name:M
Other - Last Name:HEAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1532 CRESENT OAKS LN
Mailing Address - Street 2:
Mailing Address - City:LENOIR CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37772-4199
Mailing Address - Country:US
Mailing Address - Phone:865-966-8348
Mailing Address - Fax:865-966-8349
Practice Address - Street 1:1125 GROVE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:LOUDON
Practice Address - State:TN
Practice Address - Zip Code:37774-1512
Practice Address - Country:US
Practice Address - Phone:865-966-8348
Practice Address - Fax:865-966-8349
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4022246OtherBLUE CROSS
TN3654163Medicaid
TN3654163Medicaid