Individual
DONNA A KOTILAINEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
4308 CARLISLE BLVD NE, SUITE 205, ALBUQUERQUE, NM 87107-4856
(505) 828-0232
Mailing address
2126 WISCONSIN ST NE, ALBUQUERQUE, NM 87110-4750
(505) 385-3975
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
319
NM
Other
Enumeration date
04/06/2007
Last updated
07/08/2007
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