Provider Demographics
NPI:1679907240
Name:DONAHOE, CARA (ATC)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:DONAHOE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:CARA
Other - Middle Name:
Other - Last Name:CHAMPION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:411 W AGENCY RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WEST BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52655-1704
Mailing Address - Country:US
Mailing Address - Phone:319-752-7727
Mailing Address - Fax:319-752-7774
Practice Address - Street 1:411 W AGENCY RD
Practice Address - Street 2:SUITE 1
Practice Address - City:WEST BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52655-1704
Practice Address - Country:US
Practice Address - Phone:319-752-7727
Practice Address - Fax:319-752-7774
Is Sole Proprietor?:No
Enumeration Date:2013-08-30
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0010552255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer