Provider Demographics
NPI:1114053600
Name:DUBEL, DONNA RIDGELY (PT)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:RIDGELY
Last Name:DUBEL
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 1:2058 SOUTH STATE STREET
Mailing Address - Street 2:SUITE 500
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104
Mailing Address - Country:US
Mailing Address - Phone:734-913-0300
Mailing Address - Fax:734-913-0400
Practice Address - Street 1:3145 CLARK ROAD
Practice Address - Street 2:SUITE 102
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197
Practice Address - Country:US
Practice Address - Phone:734-528-9760
Practice Address - Fax:734-528-9761
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501010716225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist