Provider Demographics
NPI:1922558394
Name:DONATO AND WOOD CONSULTING INC
Entity Type:Organization
Organization Name:DONATO AND WOOD CONSULTING INC
Other - Org Name:RIVERSIDE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:C
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-476-2502
Mailing Address - Street 1:544 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97527-5544
Mailing Address - Country:US
Mailing Address - Phone:541-476-2502
Mailing Address - Fax:541-955-5233
Practice Address - Street 1:415 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CANYONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97417-9646
Practice Address - Country:US
Practice Address - Phone:541-839-4998
Practice Address - Fax:541-839-4999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR229162Medicaid
OR229162Medicaid