MEDICARE: DR. WILLIAM JEFFREY DONAHUE D.C., L. AC.

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	111N00000X	Chiropractor	4925	AZ
2	171100000X	Acupuncturist	0183	AZ

General Provider Information

NPI Number	:	1851609127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM JEFFREY DONAHUE D.C., L. AC.

Provider Business Mailing Address
First Line	:	1744 S VAL VISTA DR
Second Line	:	SUITE 214
City	:	MESA
State	:	AZ
Zip	:	85204-7362
Country	:	US
Telephone Number	:	480-654-2920
Fax Number	:	480-424-7407

Provider Business Practice Location Address
First Line	:	1744 S VAL VISTA DR
Second Line	:	SUITE 214
City	:	MESA
State	:	AZ
Zip	:	85204-7362
Country	:	US
Telephone Number	:	480-654-2920
Fax Number	:	480-424-7407

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

Provider Enumeration Date	:	09/20/2010
Last Update Date	:	09/20/2010

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