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Kevin Donnellan, MSPT

Physical Therapist in La Jolla, CA. Individual provider (NPI-1).

NPI number1710082011
StatusActive
Last updated in NPPESApr 15, 2008

Details

NPI
1710082011
Entity type
Individual (NPI-1)
Name
Kevin Donnellan
Credential
MSPT
Sex
Male
Sole proprietor
No
Enumeration date
Sep 13, 2006
Last updated
Apr 15, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225100000X Physical Therapist33148CAYes
225100000X Physical Therapist024711NY

Practice location

7450 Girard Ave
La Jolla, CA 92037-5142

Phone 858-454-9769

Mailing address

1510 Summit Ave
Cardiff, CA 92007-2434

Phone 631-807-5354

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