Provider Demographics
NPI:1770597841
Name:RICHEY, DONNA M (PT)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:RICHEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5720 DENVER ST NE
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703-1852
Mailing Address - Country:US
Mailing Address - Phone:727-527-9311
Mailing Address - Fax:727-527-9311
Practice Address - Street 1:2100 4TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704-4312
Practice Address - Country:US
Practice Address - Phone:727-822-2361
Practice Address - Fax:727-823-8859
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT5397225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist