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NPI Code Detail

MEDICARE: JOHN P DONAHUE OTR

MEDICARE: JOHN P DONAHUE OTR
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
1225X00000XOccupational Therapist5201002957MI

General Provider Information

NPI Number : 1588620389
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN P DONAHUE OTR
Provider Business Mailing Address
First Line : 812 E JOLLY RD
Second Line : STE 210
City : LANSING
State : MI
Zip : 48910-6818
Country : US
Telephone Number : 517-346-8306
Fax Number :
Provider Business Practice Location Address
First Line : 5150 WARDCLIFF DR
Second Line :
City : EAST LANSING
State : MI
Zip : 48823-3851
Country : US
Telephone Number : 517-346-9549
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2006
Last Update Date : 03/03/2014

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