Provider Demographics
NPI:1235178815
Name:DONOVAN, JEANIENE (DC)
Entity Type:Individual
Prefix:
First Name:JEANIENE
Middle Name:
Last Name:DONOVAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-2009
Mailing Address - Country:US
Mailing Address - Phone:978-463-0985
Mailing Address - Fax:
Practice Address - Street 1:54 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-2606
Practice Address - Country:US
Practice Address - Phone:978-463-8881
Practice Address - Fax:978-463-4411
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2825111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor