MEDICARE: SHAROYN DENISE DONALDSON PT, DPT, NCS

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	2251N0400X	Neurology Physical Therapist
2	225100000X	Physical Therapist	LPT004348	AZ

General Provider Information

NPI Number	:	1801592605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAROYN DENISE DONALDSON PT, DPT, NCS

Provider Business Mailing Address
First Line	:	7000 N. 16TH ST.
Second Line	:	STE. 120-351
City	:	PHOENIX
State	:	AZ
Zip	:	85020
Country	:	US
Telephone Number	:	602-332-1775
Fax Number	:

Provider Business Practice Location Address
First Line	:	5017 E WASHINGTON ST STE 107G
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85034-2033
Country	:	US
Telephone Number	:	602-332-1775
Fax Number	:

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

Provider Enumeration Date	:	02/02/2023
Last Update Date	:	02/02/2023

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