Provider Demographics
NPI:1629771829
Name:DONATO FITNESS & WELLNESS
Entity Type:Organization
Organization Name:DONATO FITNESS & WELLNESS
Other - Org Name:FYZICAL THERAPY & BALANCE CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:DONATO
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:602-687-2066
Mailing Address - Street 1:35456 N BELGIAN BLUE CT
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85143-5500
Mailing Address - Country:US
Mailing Address - Phone:602-687-2066
Mailing Address - Fax:
Practice Address - Street 1:7115 E BASELINE RD STE 105106
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-4039
Practice Address - Country:US
Practice Address - Phone:602-687-2066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-24
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy