Provider Demographics
NPI:1508152513
Name:DONNELL, MICHAEL S (DPT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:S
Last Name:DONNELL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 PITTSBURGH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15144-1409
Mailing Address - Country:US
Mailing Address - Phone:724-275-7827
Mailing Address - Fax:724-275-7749
Practice Address - Street 1:507 PITTSBURGH ST
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:PA
Practice Address - Zip Code:15144-1409
Practice Address - Country:US
Practice Address - Phone:724-275-7827
Practice Address - Fax:724-275-7749
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT21406225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist