MEDICARE: ERICA BRYN DONLEY PT

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	5573	SC

General Provider Information

NPI Number	:	1548455041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA BRYN DONLEY PT

Provider Business Mailing Address
First Line	:	PO BOX 254
Second Line	:
City	:	OAK HILL
State	:	OH
Zip	:	45656-0254
Country	:	US
Telephone Number	:	614-256-8217
Fax Number	:

Provider Business Practice Location Address
First Line	:	2375 BAKER HOSPITAL BLVD
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29405-8233
Country	:	US
Telephone Number	:	843-744-2750
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2007
Last Update Date	:	09/08/2007

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