Individual
JOHNAS Q DOMINICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1050 S JEFFERSON DAVIS PKWY STE 325, NEW ORLEANS, LA 70125-1234
(504) 821-7085
Mailing address
1050 S JEFFERSON DAVIS PKWY, NEW ORLEANS, LA 70125-1200
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/27/2017
Last updated
11/15/2019
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