Individual
KAYLA DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
611 NORWICH AVE, COLCHESTER, CT 06415-2142
(860) 537-2378
Mailing address
179 LINWOOD AVE UNIT A-4, COLCHESTER, CT 06415-1160
(860) 603-3900
(860) 537-0636
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
001257
CT
Other
Enumeration date
09/21/2017
Last updated
09/21/2017
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