Individual
MR. DOMINIC IAN GREENFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
2345 MAIN ST, GLASTONBURY, CT 06033-2211
(262) 658-7305
Mailing address
1805 S 52ND ST, WEST MILWAUKEE, WI 53214-5412
(262) 951-5908
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
531-039
WI
Other
Enumeration date
02/23/2006
Last updated
07/08/2007
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