Provider Demographics
NPI:1104165372
Name:YODER, DONNA Y
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:Y
Last Name:YODER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:496 KELLERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MC ALISTERVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17049-8578
Mailing Address - Country:US
Mailing Address - Phone:717-463-3392
Mailing Address - Fax:
Practice Address - Street 1:496 KELLERVILLE RD
Practice Address - Street 2:
Practice Address - City:MC ALISTERVILLE
Practice Address - State:PA
Practice Address - Zip Code:17049-8578
Practice Address - Country:US
Practice Address - Phone:717-463-3392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEI000465225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant