Healthcare Provider Details

I. General information

NPI: 1376939074
Provider Name (Legal Business Name): DONNA MAGEE PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2015
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925 REEVES RD
PLAINFIELD IN
46168-5501
US

IV. Provider business mailing address

60 SWEETWOOD DR
MOORESVILLE IN
46158-1107
US

V. Phone/Fax

Practice location:
  • Phone: 317-838-7070
  • Fax:
Mailing address:
  • Phone: 317-610-6068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number06003699A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: