Individual
KELLY DONOVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
674 OVERLOOK CT, BRICK, NJ 08724-1133
(732) 439-8362
Mailing address
674 OVERLOOK CT, BRICK, NJ 08724-1133
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18KT01287900
NJ
Other
Enumeration date
09/04/2020
Last updated
09/04/2020
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