Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NX0800X | Chiropractor Orthopedic Specialist | 27 3291 | OR |
Y | 2251X0800X | Physical Therapist - Orthopedic | 4197 | OR |
NPI | 1255399325 |
---|---|
Provider Name | Dr. Miven B Donato |
First Address | Central Point, OR 97502-1573 |
Second Address | Medford, OR 97504-4340 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 22/05/2008 |