Provider Demographics
NPI:1649164534
Name:DONAHUE, KYLE J (DPT)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:J
Last Name:DONAHUE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 102831
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2831
Mailing Address - Country:US
Mailing Address - Phone:404-778-6031
Mailing Address - Fax:
Practice Address - Street 1:2021 PERNOSHAL CT STE 2200
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-6405
Practice Address - Country:US
Practice Address - Phone:404-778-6031
Practice Address - Fax:404-778-6034
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist