Individual
JACQUELINE ANN DOMECUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3273 CLAREMONT WAY STE 101, NAPA, CA 94558-3328
(707) 603-1030
Mailing address
318 TURNBERRY WAY, VALLEJO, CA 94591-4346
(707) 333-5347
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
48776
CA
Other
Enumeration date
07/20/2017
Last updated
07/22/2017
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