Provider Demographics
NPI:1134337934
Name:WEEBER, DONNA LYNN (ATC)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:LYNN
Last Name:WEEBER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1632 TAMWORTH CIR
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-6315
Mailing Address - Country:US
Mailing Address - Phone:937-866-1183
Mailing Address - Fax:
Practice Address - Street 1:5250 FAR HILLS AVE
Practice Address - Street 2:STE 220
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-2382
Practice Address - Country:US
Practice Address - Phone:937-438-3338
Practice Address - Fax:937-438-3353
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT0003552255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer