Provider Demographics
NPI:1851746564
Name:OPUSZYNSKI, DONNA (LMT)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:OPUSZYNSKI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1014 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17102-2916
Mailing Address - Country:US
Mailing Address - Phone:610-909-0097
Mailing Address - Fax:
Practice Address - Street 1:2445 WALNUT ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17103-1775
Practice Address - Country:US
Practice Address - Phone:610-909-0097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-01
Last Update Date:2016-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG002839225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist