Provider Demographics
NPI:1902119878
Name:DONALDSON, CEDRIC KENNARD (PT)
Entity Type:Individual
Prefix:DR
First Name:CEDRIC
Middle Name:KENNARD
Last Name:DONALDSON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4040 BENT RIVER LN
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-6802
Mailing Address - Country:US
Mailing Address - Phone:601-918-6980
Mailing Address - Fax:205-278-6941
Practice Address - Street 1:3517 LORNA RD
Practice Address - Street 2:SUITE 239
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216-0906
Practice Address - Country:US
Practice Address - Phone:205-800-4923
Practice Address - Fax:205-278-6941
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-21
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH6362225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist