Provider Demographics
NPI:1003418393
Name:DONNER, JAMES ROBERT (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ROBERT
Last Name:DONNER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5130 PREFERRED PL APT 213
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-7051
Mailing Address - Country:US
Mailing Address - Phone:419-560-2695
Mailing Address - Fax:
Practice Address - Street 1:720 E BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-3988
Practice Address - Country:US
Practice Address - Phone:614-224-1090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-11
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT018929225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist