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Individual

MR. DANIEL A DURHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
15765 STATE ROUTE 170, EAST LIVERPOOL, OH 43920-9070
(330) 386-5252
(330) 386-3555
Mailing address
4411 YAKOTA DORA DR, YOUNGSTOWN, OH 44511-4431
(330) 318-3957

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
08856
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000327438
ANTHEM BC/BS
OH
01
1064339
WORKERS' COMPENSATION
WV
05
2516290
OH
01
542145984
CARELINK COMMERICAL INS
OH
Enumeration date
06/21/2005
Last updated
01/26/2010
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