Provider Demographics
NPI:1891810255
Name:KEENAN, DONNA LYNNE (PT)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:LYNNE
Last Name:KEENAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:367 US RT ONE
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105
Mailing Address - Country:US
Mailing Address - Phone:207-781-5540
Mailing Address - Fax:207-781-5542
Practice Address - Street 1:U.S. ROUTE ONE
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105
Practice Address - Country:US
Practice Address - Phone:207-781-5540
Practice Address - Fax:207-781-5542
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT413225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist