Healthcare Provider Details

I. General information

NPI: 1346382694
Provider Name (Legal Business Name): BETHANY DUNN DONINGER PT, MSPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1308 W SHELBY ST
FALMOUTH KY
41040-9229
US

IV. Provider business mailing address

116 BACK STRETCH DR
GEORGETOWN KY
40324-9677
US

V. Phone/Fax

Practice location:
  • Phone: 859-654-6200
  • Fax: 859-654-1060
Mailing address:
  • Phone: 502-570-4723
  • Fax: 859-654-1060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number004305
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: