Provider Demographics
NPI:1063681203
Name:MAHAN, DONNA PAULINE
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:PAULINE
Last Name:MAHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 NORTHLAND BLVD
Mailing Address - Street 2:SUITE 231
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-3675
Mailing Address - Country:US
Mailing Address - Phone:513-771-2603
Mailing Address - Fax:
Practice Address - Street 1:230 NORTHLAND BLVD
Practice Address - Street 2:SUITE 231
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-3675
Practice Address - Country:US
Practice Address - Phone:513-771-2603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter