Individual
DR. LISA G DOMINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2510 SW WHITE BIRCH DR STE 5, ANKENY, IA 50023-7171
(515) 450-1339
(515) 964-3277
Mailing address
2510 SW WHITE BIRCH DR STE 5, ANKENY, IA 50023-7171
(515) 450-1339
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002438
IA
Other
Enumeration date
07/23/2008
Last updated
07/21/2022
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