Basic Information
| Provider Information | |||||||||
| NPI: | 1972736049 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DONLEY | ||||||||
| FirstName: | JONATHAN | ||||||||
| MiddleName: | WILLIAM | ||||||||
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| Credential: | PT, DPT, FAAOMPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 609 SPRING LAKE RD | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 292062150 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8033868442 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3010 FARROW RD | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 292037607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8034348078 | ||||||||
| FaxNumber: | 8034344331 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2009 | ||||||||
| LastUpdateDate: | 01/20/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 5156 | SC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.