Provider Demographics
NPI:1437348992
Name:O'CONNELL, DONNA MICHELLE (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:MICHELLE
Last Name:O'CONNELL
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:MS
Other - First Name:DONNA
Other - Middle Name:MICHELLE
Other - Last Name:SAUVAGEAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20347 TIMBERLAKE RD STE B
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-7352
Mailing Address - Country:US
Mailing Address - Phone:540-296-3203
Mailing Address - Fax:434-509-1695
Practice Address - Street 1:12281 MONETA RD STE B
Practice Address - Street 2:
Practice Address - City:MONETA
Practice Address - State:VA
Practice Address - Zip Code:24121-6402
Practice Address - Country:US
Practice Address - Phone:540-296-3203
Practice Address - Fax:434-509-1695
Is Sole Proprietor?:No
Enumeration Date:2007-10-22
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305004892225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC09934Medicare PIN