Provider Demographics
NPI:1104019538
Name:CROOK, DONNA M (RPTA)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:M
Last Name:CROOK
Suffix:
Gender:F
Credentials:RPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 E 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:REDFIELD
Mailing Address - State:SD
Mailing Address - Zip Code:57469-1332
Mailing Address - Country:US
Mailing Address - Phone:605-472-2948
Mailing Address - Fax:
Practice Address - Street 1:1401 PEARL ST
Practice Address - Street 2:
Practice Address - City:FAULKTON
Practice Address - State:SD
Practice Address - Zip Code:57438-2219
Practice Address - Country:US
Practice Address - Phone:605-598-6214
Practice Address - Fax:605-598-6773
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0126225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant