Individual
MR. JOHN MARK DONOVAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.O.T.
Contact information
Practice address
1501 SAN PEDRO DR SE, ALBUQUERQUE, NM 87108-5153
(505) 265-1711
Mailing address
PO BOX 10123, ALBUQUERQUE, NM 87184-0123
(505) 265-1711
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2132
NM
Other
Enumeration date
04/07/2006
Last updated
07/08/2007
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