Provider Demographics
NPI:1477869139
Name:RANKIN, DONALD BARTON JR (PT)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:BARTON
Last Name:RANKIN
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1685 HYLAND ST
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:95524-9302
Mailing Address - Country:US
Mailing Address - Phone:479-530-3695
Mailing Address - Fax:
Practice Address - Street 1:1685 HYLAND ST
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:CA
Practice Address - Zip Code:95524-9302
Practice Address - Country:US
Practice Address - Phone:479-530-3695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-19
Last Update Date:2014-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR04373225100000X
NC6507225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist