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Individual
DONALD DAMRON
Active
Individual
DONALD DAMRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-012891
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070-012891
PT STATE LICENSE #
IL
Enumeration date
01/10/2007
Last updated
06/28/2012
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