Individual
RYAN DONOVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4 PAUL AVE, PEABODY, MA 01960-2620
(781) 858-5909
Mailing address
4 PAUL AVE, PEABODY, MA 01960-2620
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2333
MA
Other
Enumeration date
09/23/2020
Last updated
09/23/2020
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