Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 05004449A | IN |
NPI | 1083165864 |
---|---|
Provider Name | Sharon K Donovan |
First Address | Carmel, IN 46032-8708 |
Second Address | Carmel, IN 46032-8708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2016 |
Last Update Date | 14/11/2016 |