Provider Demographics
NPI:1639143571
Name:FARRELL, DONNA M (ATC)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:FARRELL
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 1:4101 E BASELINE RD
Mailing Address - Street 2:#1433
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-9101
Mailing Address - Country:US
Mailing Address - Phone:480-612-1209
Mailing Address - Fax:
Practice Address - Street 1:8470 N OVERFIELD RD
Practice Address - Street 2:
Practice Address - City:COOLIDGE
Practice Address - State:AZ
Practice Address - Zip Code:85228-9030
Practice Address - Country:US
Practice Address - Phone:520-426-4306
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer