Provider Demographics
NPI:1881174993
Name:DONALDSON, BRYCE (DC)
Entity type:Individual
Prefix:
First Name:BRYCE
Middle Name:
Last Name:DONALDSON
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 1:10A WINGCO LN
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-9783
Mailing Address - Country:US
Mailing Address - Phone:610-484-3477
Mailing Address - Fax:
Practice Address - Street 1:10A WINGCO LN
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605-9783
Practice Address - Country:US
Practice Address - Phone:610-484-3477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0058382255A2300X
PADC011395111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer