Provider Demographics
NPI:1992909899
Name:JOHN J DONOVAN D.C., P.C.
Entity type:Organization
Organization Name:JOHN J DONOVAN D.C., P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:DONOVAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:978-453-0900
Mailing Address - Street 1:2 COURTHOUSE LN
Mailing Address - Street 2:SUITE #9
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-1715
Mailing Address - Country:US
Mailing Address - Phone:978-453-0900
Mailing Address - Fax:978-453-9990
Practice Address - Street 1:2 COURTHOUSE LN
Practice Address - Street 2:SUITE #9
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-1715
Practice Address - Country:US
Practice Address - Phone:978-453-0900
Practice Address - Fax:978-453-9990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MACH1646111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MADOY39534OtherBCBS OF MA. GROUP #
MADOY36160OtherBCBS OF MA. INDIVIDUAL #
MADOY39534OtherBCBS OF MA. GROUP #