MEDICARE: DONAHOO PHYSICAL THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1023435674
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DONAHOO PHYSICAL THERAPY LLC

Provider Business Mailing Address
First Line	:	400 W FORT WILLIAMS ST
Second Line	:
City	:	SYLACAUGA
State	:	AL
Zip	:	35150-2436
Country	:	US
Telephone Number	:	205-487-8040
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 W FORT WILLIAMS ST
Second Line	:
City	:	SYLACAUGA
State	:	AL
Zip	:	35150-2436
Country	:	US
Telephone Number	:	205-878-0404
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BEN DONAHOO
Credential	:
Telephone Number	:	205-259-3991

Provider Enumeration Date	:	03/20/2014
Last Update Date	:	04/30/2024

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