Individual
CASEY DONOVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, CSCS
Contact information
Practice address
1816 ROOSTER TRL, LAPEER, MI 48446-9342
(810) 338-5663
Mailing address
1816 ROOSTER TRL, LAPEER, MI 48446-9342
(810) 338-5663
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601001496
MI
Other
Enumeration date
03/30/2017
Last updated
03/30/2017
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