Individual
MR. CHARLES DONAHUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSA
Contact information
Practice address
1457 BRADDOCK LN, WYNNEWOOD, PA 19096-3104
(484) 432-2035
(206) 312-9181
Mailing address
1457 BRADDOCK LN, WYNNEWOOD, PA 19096-3104
(484) 432-2035
(206) 312-9181
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
171WH0202X
Home Modifications Contractor
—
—
171WV0202X
Vehicle Modifications Contractor
—
—
Other
Enumeration date
02/25/2015
Last updated
02/25/2015
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