Individual
THOMAS MATTHEW DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
219 S MAIN ST, MIDDLEBURY, VT 05753-1443
(803) 443-4204
Mailing address
39 EAST ST, RUTLAND, VT 05701-4128
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
104.0134001
VT
Other
Enumeration date
11/14/2023
Last updated
11/14/2023
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