Individual
SAM J DONOVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
225 S FULTON ST STE B, ITHACA, NY 14850-3344
(607) 288-3866
Mailing address
225 S FULTON ST STE B, ITHACA, NY 14850-3344
(607) 288-3866
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
030078
NY
Other
Enumeration date
06/02/2025
Last updated
06/02/2025
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