Provider Demographics
NPI:1972539880
Name:CROCHET, DONALD J (RPT)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:J
Last Name:CROCHET
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1382 SCOTT BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-1421
Mailing Address - Country:US
Mailing Address - Phone:404-377-1223
Mailing Address - Fax:404-378-4048
Practice Address - Street 1:1382 SCOTT BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1421
Practice Address - Country:US
Practice Address - Phone:404-377-1223
Practice Address - Fax:404-378-4048
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAPT0015632251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic