Individual
COURTNEY DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21638 REED RD, WATERTOWN, NY 13601-5048
(315) 786-0677
(315) 836-3782
Mailing address
259 COUNTY ROUTE 10, WHITEHALL, NY 12887-4007
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
741677131
NY
Other
Enumeration date
08/26/2013
Last updated
08/26/2013
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