Provider Demographics
NPI:1568770865
Name:PATRY, DONNA JEAN (CPTA)
Entity Type:Individual
Prefix:MR
First Name:DONNA
Middle Name:JEAN
Last Name:PATRY
Suffix:
Gender:F
Credentials:CPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2825 RESORT DR
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-9535
Mailing Address - Country:US
Mailing Address - Phone:785-826-9583
Mailing Address - Fax:785-826-9583
Practice Address - Street 1:2825 RESORT DR
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-9535
Practice Address - Country:US
Practice Address - Phone:785-826-9583
Practice Address - Fax:785-826-9583
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-00362225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant