Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 8930 | NC |
Y | 2251P0200X | Physical Therapist - Pediatrics | 13342 | AZ |
NPI | 1114259785 |
---|---|
Provider Name | Cathron Donaldson |
First Address | Flagstaff, AZ 86004-7621 |
Second Address | Flagstaff, AZ 86011-5630 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2010 |
Last Update Date | 24/10/2017 |