Individual
TIMOTHY DONOVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3400 N WESLEYAN BLVD, ROCKY MOUNT, NC 27804-8699
(252) 985-5304
Mailing address
2904 BISHOP RD, ROCKY MOUNT, NC 27804-9091
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1953
NC
Other
Enumeration date
04/25/2015
Last updated
04/25/2015
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