Individual
AMY MARIE DOMOGALIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2485 E WABASH ST STE 100, FRANKFORT, IN 46041-9400
(765) 485-8100
Mailing address
2705 N LEBANON ST STE 305, LEBANON, IN 46052-8622
(765) 485-8852
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
06000978A
IN
225200000X
Physical Therapy Assistant
Primary
06000978A
IN
Other
Enumeration date
08/25/2014
Last updated
01/03/2019
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