MR. Michael Robert Dambacher, PTA

NPI #1598210056 in Dupo, Illinois

Provider Information

NPI Number: 1598210056
Entity Type: Individual
Name: MR. Michael Robert Dambacher, PTA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Aug 24, 2016
Last Updated: Aug 24, 2016

Practice Location

Address: 95 STONEY DR
City: Dupo
State: Illinois
ZIP Code: 62239-1160
Phone: (618) 365-0249

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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