Individual
DOMINGO ATIENZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
451 W LOCKE ST, ASHDOWN, AR 71822-3325
(870) 898-4115
(870) 898-4130
Mailing address
451 W LOCKE ST, ASHDOWN, AR 71822-3325
(870) 898-4115
(870) 898-4130
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 1408
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145189721
—
AR
Enumeration date
08/04/2009
Last updated
08/04/2009
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