Provider Demographics
NPI:1720111289
Name:RIFE, DONNA J (ATC)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:J
Last Name:RIFE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2136 STOOPS CT.
Mailing Address - Street 2:PO 510
Mailing Address - City:NORTH APOLL
Mailing Address - State:PA
Mailing Address - Zip Code:15673-0510
Mailing Address - Country:US
Mailing Address - Phone:724-842-0404
Mailing Address - Fax:724-845-5011
Practice Address - Street 1:200 POPLAR ST
Practice Address - Street 2:
Practice Address - City:VANDERGRIFT
Practice Address - State:PA
Practice Address - Zip Code:15690-1466
Practice Address - Country:US
Practice Address - Phone:724-842-0404
Practice Address - Fax:724-845-5011
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0001069A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer