Individual
LISA AMANDA DONALDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, MBA
Contact information
Practice address
2701 FAIRVIEW RD, COSTA MESA, CA 92626-5563
(714) 559-0231
Mailing address
9304 W PLAINFIELD AVE, GREENFIELD, WI 53228-2118
(414) 388-1918
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000017880
WI
Other
Enumeration date
03/12/2018
Last updated
03/12/2018
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