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Individual

DONAVAN ANTHONY ROMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2110 FOX DR STE D, CHAMPAIGN, IL 61820-7553
(217) 398-9800
Mailing address
2110 FOX DR STE D, CHAMPAIGN, IL 61820-7553
(217) 398-9800

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.010625
IL

Other

Enumeration date
04/23/2026
Last updated
04/23/2026
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