Provider Demographics
NPI:1629357504
Name:ADAIR, DONNA BRYAN HOWELL (COTA)
Entity Type:Individual
Prefix:
First Name:DONNA BRYAN
Middle Name:HOWELL
Last Name:ADAIR
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13150 NC HWY 96N
Mailing Address - Street 2:
Mailing Address - City:ZEBULON
Mailing Address - State:NC
Mailing Address - Zip Code:27597
Mailing Address - Country:US
Mailing Address - Phone:919-333-7641
Mailing Address - Fax:
Practice Address - Street 1:13150 NC HIGHWAY 96 N
Practice Address - Street 2:
Practice Address - City:ZEBULON
Practice Address - State:NC
Practice Address - Zip Code:27597-7420
Practice Address - Country:US
Practice Address - Phone:919-333-7641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2610174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist