Provider Demographics
NPI:1699040808
Name:STODDARD, DONNA M (DPT)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:STODDARD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:280 BOSTON TPKE
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-2640
Mailing Address - Country:US
Mailing Address - Phone:508-853-4590
Mailing Address - Fax:949-756-4811
Practice Address - Street 1:145 CHURCH ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MA
Practice Address - Zip Code:01510-2560
Practice Address - Country:US
Practice Address - Phone:978-598-3155
Practice Address - Fax:978-365-5600
Is Sole Proprietor?:No
Enumeration Date:2012-03-21
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA16563225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist