Provider Demographics
NPI:1104082510
Name:GREENHOWARD, DONA L (RPT/MED)
Entity type:Individual
Prefix:MR
First Name:DONA
Middle Name:L
Last Name:GREENHOWARD
Suffix:
Gender:F
Credentials:RPT/MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20107 NE 23RD ST
Mailing Address - Street 2:
Mailing Address - City:HARRAH
Mailing Address - State:OK
Mailing Address - Zip Code:73045-9116
Mailing Address - Country:US
Mailing Address - Phone:405-454-0010
Mailing Address - Fax:405-454-0030
Practice Address - Street 1:20107 NE 23RD ST
Practice Address - Street 2:
Practice Address - City:HARRAH
Practice Address - State:OK
Practice Address - Zip Code:73045-9116
Practice Address - Country:US
Practice Address - Phone:405-454-0010
Practice Address - Fax:405-454-0030
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT1735225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist