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Individual

MRS. TARA LYNN DOMMERT-HARRISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
IDMT

Contact information

Practice address
2900 DOOLITTLE DR, ELLSWORTH AFB, SD 57706-4821
(605) 385-3433
Mailing address
1317 SUMMERFIELD DR, RAPID CITY, SD 57703-4709
(813) 758-5469

Taxonomy

Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary

Other

Enumeration date
04/23/2009
Last updated
11/30/2009
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