Individual
DOMINIQUE Y CORDOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
435 NW RUTLAND RD, MOUNT JULIET, TN 37122-8700
(615) 773-6111
Mailing address
9925 SW 82ND AVE, MIAMI, FL 33156-2513
(305) 450-4475
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA28180
FL
Other
Enumeration date
07/15/2022
Last updated
07/15/2022
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