Provider Demographics
NPI:1417404138
Name:DONOVAN, MARGARET (PT)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:DONOVAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 W LULL PL
Mailing Address - Street 2:
Mailing Address - City:NEW BOSTON
Mailing Address - State:NH
Mailing Address - Zip Code:03070-3521
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12 W LULL PL
Practice Address - Street 2:
Practice Address - City:NEW BOSTON
Practice Address - State:NH
Practice Address - Zip Code:03070-3521
Practice Address - Country:US
Practice Address - Phone:603-703-2002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-10
Last Update Date:2016-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA112872251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic