Healthcare Provider Details

I. General information

NPI: 1750066486
Provider Name (Legal Business Name): JOSHUA DONKOR MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2023
Last Update Date: 06/20/2023
Certification Date: 06/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 SMITH AVE N
SAINT PAUL MN
55102-2533
US

IV. Provider business mailing address

225 SMITH AVE N
SAINT PAUL MN
55102-2533
US

V. Phone/Fax

Practice location:
  • Phone: 651-353-9662
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Y00000X
TaxonomyClinical Exercise Physiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: