Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 2358 | OH |
NPI | 1043373962 |
---|---|
Provider Name | Dr. Thomas Donahue |
First Address | Hilliard, OH 43026-2495 |
Second Address | Hilliard, OH 43026-2495 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0459310 | (05) | OH |
465300 | (02) | OH |