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General NPI Number Information
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NPI Number | 1497085393
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Entity Type | Individual
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Provider Name | DONNOVAN DOLATO ATC, CSCS, NSCA-CPT
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Gender | Male
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Dates
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Enumeration Date | 12/28/2009
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Last Update Date | 12/28/2009
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Provider Practice Location Address
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Address Line | 10996 RIVER FRONT PKWY
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-3538
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Country | US
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Telephone | 801-302-0909
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Fax |
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Provider Business Mailing Address
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Address Line | 1079 E 8320 S
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City | SANDY
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State | UT
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Zip | 84094-0708
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Country | US
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Telephone | 801-712-5626
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State | UT
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