Individual
JESUS DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1120 N TOWN CENTER DR, SUITE 120, LAS VEGAS, NV 89144-6301
(866) 960-7691
(866) 960-7692
Mailing address
5370 E CRAIG RD, LAS VEGAS, NV 89115-2100
(702) 994-4358
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
06/28/2012
Last updated
06/28/2012
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