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General NPI Number Information
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NPI Number | 1295514289
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Entity Type | Individual
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Provider Name | ELIZABETH DONOVAN PT
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Gender | Female
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Dates
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Enumeration Date | 09/27/2023
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 1880 CLARKSON RD
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City | CHESTERFIELD
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State | MO
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Zip | 63017-5000
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Country | US
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Telephone | 314-644-1978
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Fax |
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Provider Business Mailing Address
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Address Line | 2045 WAKEFIELD FARM RD
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City | WILDWOOD
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State | MO
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Zip | 63038-1213
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Country | US
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Telephone | 425-677-4383
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 108900
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License Number State | MO
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