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NPI Code Detail

MEDICARE: DR. AMANDA DONAHUE PT, DPT

MEDICARE: DR. AMANDA DONAHUE PT, DPT
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
1225100000XPhysical Therapist27033MA

General Provider Information

NPI Number : 1265216113
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMANDA DONAHUE PT, DPT
Provider Business Mailing Address
First Line : 160 FREMONT ST UNIT 414
Second Line :
City : WORCESTER
State : MA
Zip : 01603-2376
Country : US
Telephone Number : 774-278-1274
Fax Number :
Provider Business Practice Location Address
First Line : 93 STAFFORD ST
Second Line :
City : WORCESTER
State : MA
Zip : 01603-1459
Country : US
Telephone Number : 508-593-1890
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2023
Last Update Date : 08/22/2023

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Directions to “ DR. AMANDA DONAHUE PT, DPT” Practice Location

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