Provider Demographics
NPI:1518936111
Name:WITTEN, DONNA LYNN (MS PT)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:LYNN
Last Name:WITTEN
Suffix:
Gender:F
Credentials:MS PT
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Mailing Address - Street 1:6211 POST OAK TER
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76112-1708
Mailing Address - Country:US
Mailing Address - Phone:817-457-5689
Mailing Address - Fax:
Practice Address - Street 1:17817 DAVENPORT RD
Practice Address - Street 2:SUITE 230
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-5871
Practice Address - Country:US
Practice Address - Phone:972-732-7797
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX146142225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T2075OtherBCBS ID NUMBER
TX8T2075OtherBCBS ID NUMBER