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Organization
DOMINICK 'S ANESTHESIA SERVICE INC
Active
Organization
DOMINICK 'S ANESTHESIA SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOMINICK PETER PALMISANO C.R.N.A. (PRESIDENT)
(918) 260-9749
Entity
Organization
Contact information
Practice address
17781 S.543 ROAD, TAHLEQUAH, OK 74464-2000
(918) 207-0727
Mailing address
P.O.BOX 398, TAHLEQUAH, OK 74465-0398
(918) 260-9749
Taxonomy
Speciality
Code
Description
License number
State
282NR1301X
Rural Acute Care Hospital
Primary
ROO49310
OK
Other
Enumeration date
10/18/2006
Last updated
08/22/2020
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