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Organization
WILLOW MEDICAL GROUP
Active
Organization
WILLOW MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE J DOMARACKI (CO-OWNER DC)
(562) 424-4976
Entity
Organization
Contact information
Practice address
3311 E WILLOW ST, LONG BEACH, CA 90806
(562) 424-4976
(562) 424-5960
Mailing address
3311 E WILLOW ST, LONG BEACH, CA 90806
(562) 424-4976
(562) 424-5960
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC 20570
CA
207LP2900X
Pain Medicine (Anesthesiology) Physician
G59739
CA
207XS0117X
Orthopaedic Surgery of the Spine Physician
A38436
CA
Other
Enumeration date
06/23/2006
Last updated
01/04/2008
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