Individual
MS. MARY DONAHUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 HOSPITAL DR, TOWANDA, PA 18848-9710
(570) 265-2191
(570) 268-2379
Mailing address
1 HOSPITAL DR, TOWANDA, PA 18848-9710
(570) 265-2191
(570) 268-2379
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE001339L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TE001339L
LICENSE NUMBER
PA
Enumeration date
02/15/2007
Last updated
07/08/2007
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