Provider Demographics
NPI:1396021630
Name:RAMIREZ, DONNA L (MSPT)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:L
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1614 COLONY LN
Mailing Address - Street 2:
Mailing Address - City:BROOKLET
Mailing Address - State:GA
Mailing Address - Zip Code:30415-6173
Mailing Address - Country:US
Mailing Address - Phone:912-842-7106
Mailing Address - Fax:
Practice Address - Street 1:1614 COLONY LN
Practice Address - Street 2:
Practice Address - City:BROOKLET
Practice Address - State:GA
Practice Address - Zip Code:30415-6173
Practice Address - Country:US
Practice Address - Phone:912-842-7106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA6724225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist