Provider Demographics
NPI:1629778980
Name:MACLEOD, DONALD (DPT, PT, MBA)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:MACLEOD
Suffix:
Gender:M
Credentials:DPT, PT, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 E ROCK HAVEN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISONVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64701-4411
Mailing Address - Country:US
Mailing Address - Phone:816-887-0304
Mailing Address - Fax:816-887-0305
Practice Address - Street 1:2800 E ROCK HAVEN RD
Practice Address - Street 2:
Practice Address - City:HARRISONVILLE
Practice Address - State:MO
Practice Address - Zip Code:64701-4411
Practice Address - Country:US
Practice Address - Phone:168-870-3048
Practice Address - Fax:816-887-0305
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017026957225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist