Provider Demographics
NPI:1053464388
Name:WIEJKUS, DONNA ELIZABETH (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:ELIZABETH
Last Name:WIEJKUS
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
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Mailing Address - Street 1:2001 FALLS BLVD
Mailing Address - Street 2:APT # 101
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169
Mailing Address - Country:US
Mailing Address - Phone:617-797-7930
Mailing Address - Fax:
Practice Address - Street 1:33 POND AVE
Practice Address - Street 2:SUITE 107B
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-7163
Practice Address - Country:US
Practice Address - Phone:617-232-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MA163202251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Not Answered2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic