Provider Demographics
NPI:1598787483
Name:DONOVAN, JOAN M (LMT)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:M
Last Name:DONOVAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MRS
Other - First Name:JOAN
Other - Middle Name:M
Other - Last Name:ALGIERE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT, MMT, NKT
Mailing Address - Street 1:4001 W CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-2204
Mailing Address - Country:US
Mailing Address - Phone:419-367-1417
Mailing Address - Fax:419-491-1122
Practice Address - Street 1:4001 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-2204
Practice Address - Country:US
Practice Address - Phone:419-367-1417
Practice Address - Fax:419-491-1122
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.012746225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist