Individual
DR. KENNETH DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
3715 PATRIOT WAY STE 143, WILMINGTON, NC 28412-6901
(910) 395-2774
(910) 395-2474
Mailing address
3715 PATRIOT WAY STE 143, WILMINGTON, NC 28412-6901
(910) 395-2774
(910) 395-2474
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2688
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085T2
BC/BS
NC
Enumeration date
08/29/2006
Last updated
07/08/2007
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