Provider Demographics
NPI:1790722023
Name:JENKINS, DONNA SALIBA (PT)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:SALIBA
Last Name:JENKINS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:MAY
Other - Last Name:BARBOUR , SALIBA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:8823 PRODUCTION LN
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6511
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:3780 HOLCOMB BRIDGE RD
Practice Address - Street 2:SUITE E
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-2701
Practice Address - Country:US
Practice Address - Phone:770-368-8999
Practice Address - Fax:770-368-9434
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP7336Medicare ID - Type UnspecifiedGROUP NUMBER