Individual
PEDRO ARMANDO MANJARREZ DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 PETER THEIN AVE UNIT D, BELGIUM, WI 53004-9520
(479) 249-5624
Mailing address
101 PETER THEIN AVE UNIT D, BELGIUM, WI 53004-9520
(479) 249-5624
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4424-154
WI
Other
Enumeration date
06/15/2017
Last updated
07/21/2022
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