Healthcare Provider Details

I. General information

NPI: 1336711324
Provider Name (Legal Business Name): RAD HEALTH & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2021
Last Update Date: 07/11/2021
Certification Date: 07/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 EAYRESTOWN RD
SOUTHAMPTON NJ
08088-9122
US

IV. Provider business mailing address

133 EAYRESTOWN RD
SOUTHAMPTON NJ
08088-9122
US

V. Phone/Fax

Practice location:
  • Phone: 609-233-9305
  • Fax:
Mailing address:
  • Phone: 609-233-9305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. RONALD ALLEN DONATO JR.
Title or Position: OWNER
Credential: DC
Phone: 609-233-9305