Individual
MR. DUSTIN J DONAHUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMBT #4824
Contact information
Practice address
630 S BENNETT ST STE 2, SOUTHERN PINES, NC 28387-5920
(910) 973-1049
Mailing address
125 WOODED ACRE WAY, CAMERON, NC 28326-0108
(910) 973-1049
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
4824
NC
Other
Enumeration date
12/14/2020
Last updated
12/14/2020
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