Provider Demographics
NPI:1518008556
Name:PERRY, DONALD (PT)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:
Last Name:PERRY
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 1:1016 HYGEIA AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1708
Mailing Address - Country:US
Mailing Address - Phone:760-632-5552
Mailing Address - Fax:760-230-1539
Practice Address - Street 1:365 S RANCHO SANTA FE RD
Practice Address - Street 2:SUITE 205
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-2338
Practice Address - Country:US
Practice Address - Phone:760-471-9953
Practice Address - Fax:760-471-9956
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT2615225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist