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1245099514
DONOVAN ALEXANDER INNISS
BOSTON, MA
NPI
1245099514
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-03-18
Last Update Date
2024-03-18
Business Address
DONOVAN ALEXANDER INNISS
55 FRUIT ST
BOSTON, MA 02114-2621
Phone number: 617-724-4068
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Mailing Address
DONOVAN ALEXANDER INNISS
55 FRUIT ST
BOSTON, MA 02114-2621
Phone number:
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