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Individual

DAMON ANTHONY FORMAINI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MPT

Contact information

Practice address
5 FRANKLIN VILLAGE MALL, KITTANNING, PA 16201-8803
(724) 543-6452
(724) 543-5617
Mailing address
430 INNOVATION DRIVE, BLAIRSVILLE, PA 15717-8096
(724) 343-4060
(724) 343-4069

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT010972L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
232918467
AETNA
PA
01
457005
HEALTH AMERICA-ASSURANCE
PA
01
FO1908605
HIGHMARK BLUE SHIELD
PA
Enumeration date
11/29/2006
Last updated
01/15/2015
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