Individual
MAUREEN CECILIA DONNELLY II
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
CORNER OF ROUTE N12 AND N7, FORT DEFIANCE, AZ 86504-0649
(929) 729-8810
Mailing address
PO BOX 649, FORT DEFIANCE, AZ 86504-0649
(505) 929-8810
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3049
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780630491
GROUP NPI #
NM
Enumeration date
10/12/2006
Last updated
10/26/2012
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