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General NPI Number Information
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NPI Number | 1598086852
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Entity Type | Organization
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Legal Business Name | DONNER PHYSICAL THERAPY AND SPORTS REHAB INC
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Dates
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Enumeration Date | 06/21/2010
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Last Update Date | 09/17/2019
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Provider Practice Location Address
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Address Line | 8040 PETERS RD STE H107
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City | PLANTATION
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State | FL
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Zip | 33324-4029
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Country | US
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Telephone | 954-296-8258
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Fax |
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Provider Business Mailing Address
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Address Line | 1021 S UNIVERSITY DR SUITE 220
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City | PLANTATION
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State | FL
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Zip | 33324-3321
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Country | US
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Telephone | 954-804-7501
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MATT DONNER
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Credential | PT
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Telephone | 954-804-7501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 16055
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License Number State | FL
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