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Individual
MR. JUNZEN BALLESIL DOMINGO
Active
Individual
MR. JUNZEN BALLESIL DOMINGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT27829
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D552-4227-8028
DMV
IL
Enumeration date
07/20/2012
Last updated
03/24/2025
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