Healthcare Provider Details
I. General information
NPI: 1811930506
Provider Name (Legal Business Name): DONALD SHOWALTER PT, CHT
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/13/2006
Last Update Date: 01/17/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7201 TURNER LAKE RD NE STE 13
COVINGTON GA
30014
US
IV. Provider business mailing address
1200 CORPORATE DR STE 400
HOOVER AL
35242-5424
US
V. Phone/Fax
- Phone: 470-444-1609
- Fax:
- Phone: 423-238-7217
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2251X0800X |
| Taxonomy | Orthopedic Physical Therapist |
| License Number | PT000649 |
| License Number State | GA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251H1200X |
| Taxonomy | Hand Physical Therapist |
| License Number | PT000649 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: