Provider Demographics
NPI:1609148113
Name:DONOHUE CHIROPRACTIC
Entity Type:Organization
Organization Name:DONOHUE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:DONOHUE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:609-680-1488
Mailing Address - Street 1:650 DURHAM ROAD
Mailing Address - Street 2:SUITE #2
Mailing Address - City:WRIGHTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-9618
Mailing Address - Country:US
Mailing Address - Phone:215-598-7750
Mailing Address - Fax:
Practice Address - Street 1:650 DURHAM RD
Practice Address - Street 2:SUITE #2
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-9618
Practice Address - Country:US
Practice Address - Phone:215-598-7750
Practice Address - Fax:215-598-7750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-30
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009650111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ172 357Medicare PIN