Provider Demographics
NPI:1447544218
Name:PONESSA, DONNA KAY (LMT)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:KAY
Last Name:PONESSA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1864 OREGON PIKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-6402
Mailing Address - Country:US
Mailing Address - Phone:717-519-6700
Mailing Address - Fax:717-519-6722
Practice Address - Street 1:1864 OREGON PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-6402
Practice Address - Country:US
Practice Address - Phone:717-519-6700
Practice Address - Fax:717-519-6722
Is Sole Proprietor?:No
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG000413225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist