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General NPI Number Information
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NPI Number | 1497302509
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Entity Type | Individual
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Provider Name | ANGELICA DONATO DC
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Gender | Female
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Dates
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Enumeration Date | 08/22/2019
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Last Update Date | 08/22/2019
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Provider Practice Location Address
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Address Line | 3369 BUFORD HWY NE STE 820
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City | BROOKHAVEN
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State | GA
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Zip | 30329-1742
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Country | US
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Telephone | 787-215-0981
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 BARONE AVE NE APT 1515
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City | BROOKHAVEN
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State | GA
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Zip | 30329-1851
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Country | US
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Telephone | 787-215-0981
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHIRO010247
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License Number State | GA
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