Provider Demographics
NPI:1578944047
Name:DONATO AND WOOD CONSULTING INC
Entity Type:Organization
Organization Name:DONATO AND WOOD CONSULTING INC
Other - Org Name:RIVERSIDE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDSEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DONATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-955-0940
Mailing Address - Street 1:544 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97527-5544
Mailing Address - Country:US
Mailing Address - Phone:541-955-0940
Mailing Address - Fax:541-955-5233
Practice Address - Street 1:544 UNION AVE
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97527-5544
Practice Address - Country:US
Practice Address - Phone:541-955-0940
Practice Address - Fax:541-955-5233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-10
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR04306261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR3949540002Medicare NSC