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Individual

KELLY ANN DONATHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT, ATC

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11279
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9844
MN BOARD OF PT
MN
Enumeration date
06/28/2011
Last updated
08/05/2015
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