Provider Demographics
NPI:1366579518
Name:DAVIDOW, PHILIP A (MPT PHYSICAL THERAPY)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:A
Last Name:DAVIDOW
Suffix:
Gender:M
Credentials:MPT PHYSICAL THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:120 WILLIAM PENN PLZ
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-2150
Mailing Address - Country:US
Mailing Address - Phone:919-220-5255
Mailing Address - Fax:919-313-1276
Practice Address - Street 1:1236 HUFFMAN MILL RD
Practice Address - Street 2:SUITE 1300
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-8700
Practice Address - Country:US
Practice Address - Phone:336-584-5544
Practice Address - Fax:336-584-4438
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC6900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist