Provider Demographics
NPI:1770693590
Name:DONNER, GUY (DC)
Entity type:Individual
Prefix:
First Name:GUY
Middle Name:
Last Name:DONNER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 ROUTE 37 E
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-5563
Mailing Address - Country:US
Mailing Address - Phone:732-861-0983
Mailing Address - Fax:732-281-0054
Practice Address - Street 1:213 ROUTE 37 E
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-5563
Practice Address - Country:US
Practice Address - Phone:732-861-0983
Practice Address - Fax:732-281-0054
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MCOD311800111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T45292Medicare UPIN
NJ452739Medicare PIN