Provider Demographics
NPI:1487638557
Name:DONALD, DOUGLAS A (PT)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:A
Last Name:DONALD
Suffix:
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 1:279 NEWBURN DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15216-1229
Mailing Address - Country:US
Mailing Address - Phone:412-344-6489
Mailing Address - Fax:
Practice Address - Street 1:1136 THORN RUN RD
Practice Address - Street 2:
Practice Address - City:MOON TWP
Practice Address - State:PA
Practice Address - Zip Code:15108-4301
Practice Address - Country:US
Practice Address - Phone:412-269-2275
Practice Address - Fax:412-269-2276
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT008248225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist