Provider Demographics
NPI:1316319395
Name:TROY PHYSICAL MEDICINE AND REHAB, LLC
Entity type:Organization
Organization Name:TROY PHYSICAL MEDICINE AND REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:DANON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-335-2722
Mailing Address - Street 1:1001 S DORSET RD STE C
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-4750
Mailing Address - Country:US
Mailing Address - Phone:937-335-2722
Mailing Address - Fax:937-339-6775
Practice Address - Street 1:1001 S DORSET RD STE C
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-4750
Practice Address - Country:US
Practice Address - Phone:937-335-2722
Practice Address - Fax:937-339-6775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-29
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty