Provider Demographics
NPI:1366524951
Name:DONNER, MINDAL R (DC)
Entity type:Individual
Prefix:DR
First Name:MINDAL
Middle Name:R
Last Name:DONNER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2316 SAINT BRIDES RD W
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-2215
Mailing Address - Country:US
Mailing Address - Phone:757-642-2735
Mailing Address - Fax:
Practice Address - Street 1:2316 SAINT BRIDES RD W
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-2215
Practice Address - Country:US
Practice Address - Phone:757-642-2735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556333111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAV05343Medicare UPIN