MEDICARE: DANIEL DONALDSON PTA

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	2781	OK

General Provider Information

NPI Number	:	1508736869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL DONALDSON PTA

Provider Business Mailing Address
First Line	:	9016 S FULTON AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74137-3589
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9016 S FULTON AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74137-3589
Country	:	US
Telephone Number	:	918-313-1242
Fax Number	:

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

Provider Enumeration Date	:	11/10/2025
Last Update Date	:	11/10/2025

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Directions to “ DANIEL DONALDSON PTA” Practice Location

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