Provider Demographics
NPI:1588998611
Name:DONELSON, LOIS H (PT, DIP MDT)
Entity type:Individual
Prefix:MS
First Name:LOIS
Middle Name:H
Last Name:DONELSON
Suffix:
Gender:F
Credentials:PT, DIP MDT
Other - Prefix:MS
Other - First Name:LOIS
Other - Middle Name:E
Other - Last Name:HANNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:45 LYME RD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:HANOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03755-1219
Mailing Address - Country:US
Mailing Address - Phone:603-653-0040
Mailing Address - Fax:603-653-0041
Practice Address - Street 1:45 LYME RD
Practice Address - Street 2:SUITE 303
Practice Address - City:HANOVER
Practice Address - State:NH
Practice Address - Zip Code:03755-1219
Practice Address - Country:US
Practice Address - Phone:603-653-0040
Practice Address - Fax:603-653-0041
Is Sole Proprietor?:No
Enumeration Date:2009-09-22
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT24684225100000X
NHPT2245225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist