Individual
ROSE MARIE DOMNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 CHIEF EDDIE HOFFMAN HIGHWAY, BETHEL, AK 99559
(907) 543-6100
Mailing address
PO BOX 287, BETHEL, AK 99559-0287
(907) 543-6738
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020986
—
AK
Enumeration date
02/02/2021
Last updated
02/02/2021
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