Provider Demographics
NPI:1255900171
Name:DURANTE, DAWN (PT)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:DURANTE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7860 FARR ST
Mailing Address - Street 2:
Mailing Address - City:DANIEL ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29492-8368
Mailing Address - Country:US
Mailing Address - Phone:843-813-5808
Mailing Address - Fax:
Practice Address - Street 1:311 JOHNNIE DODDS BLVD UNIT 111
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-2975
Practice Address - Country:US
Practice Address - Phone:843-416-8718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5952208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation