Individual
JOSEPH DOMANICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2250 HICKORY RD, SUITE 240, PLYMOUTH MEETING, PA 19462-1047
(800) 879-4471
Mailing address
4620 BARRY RD, PHILADELPHIA, PA 19114-3706
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC006882L
PA
Other
Enumeration date
07/21/2009
Last updated
07/21/2009
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