MEDICARE: SATU DONAHOE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	PA4912	ME

General Provider Information

NPI Number	:	1326555319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SATU DONAHOE

Provider Business Mailing Address
First Line	:	85 HARRISON HEIGHTS RD
Second Line	:
City	:	HARRISON
State	:	ME
Zip	:	04040
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	85 HARRISON HEIGHTS RD
Second Line	:
City	:	HARRISON
State	:	ME
Zip	:	04040
Country	:	US
Telephone Number	:	339-788-0475
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2017
Last Update Date	:	12/29/2017

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Directions to “ SATU DONAHOE ” Practice Location

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