Provider Demographics
NPI:1992814511
Name:D'AMICO, FRANCINE M (PT)
Entity type:Individual
Prefix:MRS
First Name:FRANCINE
Middle Name:M
Last Name:D'AMICO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:FRANCINE
Other - Middle Name:M
Other - Last Name:D'AMICO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:12357 HAYNES ST.
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:LA
Mailing Address - Zip Code:70722-8508
Mailing Address - Country:US
Mailing Address - Phone:225-683-1125
Mailing Address - Fax:225-683-1127
Practice Address - Street 1:12357 HAYNES ST.
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:LA
Practice Address - Zip Code:70722-8508
Practice Address - Country:US
Practice Address - Phone:225-683-1125
Practice Address - Fax:225-683-1127
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA01239225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3A064CW38Medicare PIN