Provider Demographics
NPI:1831103373
Name:DONNER, MATTHEW HUSTED (R PT)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:HUSTED
Last Name:DONNER
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Gender:M
Credentials:R PT
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Mailing Address - Street 1:8040 PETERS RD
Mailing Address - Street 2:STE H107
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-4029
Mailing Address - Country:US
Mailing Address - Phone:513-742-2333
Mailing Address - Fax:513-742-0943
Practice Address - Street 1:861 N NOB HILL ROAD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324
Practice Address - Country:US
Practice Address - Phone:954-577-5705
Practice Address - Fax:954-577-0168
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2019-09-12
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY6951ZMedicare ID - Type Unspecified