Provider Demographics
NPI:1144420654
Name:BISHOP, DONNA KAY (LPTA)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:KAY
Last Name:BISHOP
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 COURTHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740-2421
Mailing Address - Country:US
Mailing Address - Phone:304-487-3458
Mailing Address - Fax:304-425-1924
Practice Address - Street 1:315 COURTHOUSE RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-2421
Practice Address - Country:US
Practice Address - Phone:304-487-3458
Practice Address - Fax:304-425-1924
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV001008225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant