Provider Demographics
NPI:1649597782
Name:PIZZUTO, DONNA MARY (LMT/NCTMB)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:MARY
Last Name:PIZZUTO
Suffix:
Gender:F
Credentials:LMT/NCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2028 REGENCY RD
Mailing Address - Street 2:STE 100
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503
Mailing Address - Country:US
Mailing Address - Phone:859-576-7597
Mailing Address - Fax:
Practice Address - Street 1:2028 REGENCY RD
Practice Address - Street 2:STE 100
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2358
Practice Address - Country:US
Practice Address - Phone:859-576-7597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-29
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1932225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist