Healthcare Provider Details

I. General information

NPI: 1346580891
Provider Name (Legal Business Name): KATHLEEN A DONOHUE PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2013
Last Update Date: 02/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

687 BENT CREEK DR
LITITZ PA
17543-8350
US

IV. Provider business mailing address

687 BENT CREEK DR
LITITZ PA
17543-8350
US

V. Phone/Fax

Practice location:
  • Phone: 717-569-1888
  • Fax:
Mailing address:
  • Phone: 717-569-1888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT004008E
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: