Provider Demographics
NPI:1376837609
Name:ADKINS, DONNA JO (LMT)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:JO
Last Name:ADKINS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 BEECHUST AVE
Mailing Address - Street 2:SUITE 12
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-9998
Mailing Address - Country:US
Mailing Address - Phone:304-292-0293
Mailing Address - Fax:304-292-0293
Practice Address - Street 1:709 BEECHUST AVE
Practice Address - Street 2:SUITE 12 SENECA CENTER
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-9998
Practice Address - Country:US
Practice Address - Phone:304-292-0293
Practice Address - Fax:304-292-0293
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-03
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2005-1860173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist