# DONOVAN CHIROPRACTIC AND WELLNESS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871732529
- **Authorized official:** DR. MARK J DONOVAN D.C. (CHIROPRACTOR)
- **Authorized official phone:** (920) 251-9650

## Contact information

- **Practice address:** 976 E JOHNSON ST, SUITE 900, FOND DU LAC, WI 54935-9746
- **Practice address phone:** (920) 251-9650
- **Mailing address:** 976 E JOHNSON ST, SUITE 900, FOND DU LAC, WI 54935-9746

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 4476-12 | WI | Yes |

## Other

- **Enumeration date:** 02/19/2009
- **Last updated:** 02/19/2009