Provider Demographics
NPI:1083070866
Name:DONATELLI, ALLISON BOWEN (PT)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:BOWEN
Last Name:DONATELLI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 WHISPERWOOD LN
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30605-7077
Mailing Address - Country:US
Mailing Address - Phone:706-461-0851
Mailing Address - Fax:
Practice Address - Street 1:1305 JENNINGS MILL RD STE 170
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-0037
Practice Address - Country:US
Practice Address - Phone:706-552-1923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-08
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT008786225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist