Provider Demographics
NPI:1063699403
Name:PIMBLE, DONNA LOUISE (MS PT)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:LOUISE
Last Name:PIMBLE
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:28 BALSAM CT
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18966-2164
Mailing Address - Country:US
Mailing Address - Phone:267-303-2805
Mailing Address - Fax:
Practice Address - Street 1:1 NORTH BELFIELD AVE
Practice Address - Street 2:SUNNY DAYS
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083
Practice Address - Country:US
Practice Address - Phone:610-449-1600
Practice Address - Fax:610-449-2655
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2022-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT012358L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019225300004Medicaid