Provider Demographics
NPI:1639444946
Name:MCDONALD, CHARLSEY LEIGH (DPT)
Entity Type:Individual
Prefix:MRS
First Name:CHARLSEY
Middle Name:LEIGH
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:DPT
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Mailing Address - Street 1:8100 WYOMING BLVD NE STE M4
Mailing Address - Street 2:#261
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-1963
Mailing Address - Country:US
Mailing Address - Phone:505-797-5505
Mailing Address - Fax:505-797-5510
Practice Address - Street 1:7920 CARMEL AVE. NE
Practice Address - Street 2:SUITE 2
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87122
Practice Address - Country:US
Practice Address - Phone:505-797-5505
Practice Address - Fax:505-797-5510
Is Sole Proprietor?:No
Enumeration Date:2012-03-20
Last Update Date:2012-03-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NM4062225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist