| Doctor Name: | DAMON STURDIVANT |
| NPI Number: | 1336527811 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPT |
| License Number: | PT3517 |
| Business Practice Address: | 2744 E Millennium Pl Suite 2 Fayetteville, AR - 727034798 |
| Business Phone Number: | 4795827213 |
| Business Fax Number: | 4795211843 |
| Mailing Address: | Po Box 1523, FAYETTEVILLE |
| State: | AR |
| Postal Code: | 727021523 |
| Phone Number: | 4795716038 |
| Fax Number: | 4795820222 |
| NPI Enumeration Date: | 05/15/2015 |
| NPI Last Update Date: | 05/15/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT3517 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |