Provider Demographics
NPI:1336726538
Name:DARM, JUSTIN (CP)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:DARM
Suffix:
Gender:M
Credentials:CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 CENTURY BLVD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-3693
Mailing Address - Country:US
Mailing Address - Phone:615-346-6213
Mailing Address - Fax:615-346-6225
Practice Address - Street 1:356 24TH AVE N STE 300
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1569
Practice Address - Country:US
Practice Address - Phone:615-301-5264
Practice Address - Fax:615-340-4537
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPRO0000000231335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier