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General NPI Number Information
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NPI Number | 1629771829
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Entity Type | Organization
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Legal Business Name | DONATO FITNESS AND WELLNESS LLC
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Dates
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Enumeration Date | 03/24/2023
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 7115 E BASELINE RD STE 105
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City | MESA
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State | AZ
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Zip | 85209-4039
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Country | US
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Telephone | 602-853-4404
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Fax | 602-853-4776
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Provider Business Mailing Address
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Address Line | 7115 E BASELINE RD STE 105
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City | MESA
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State | AZ
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Zip | 85209-4039
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Country | US
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Telephone | 602-853-4404
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Fax | 602-853-4776
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Authorized Official
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Title or Position | CEO
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Name | JARED ELLIOT JAMES SIDHU
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Credential |
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Telephone | 480-604-4555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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