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Individual

DOMINICK CARMEN MASCOLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NREMT

Contact information

Practice address
BLDG 301 ANDREWS AVE, LYSTER ARMY HEALTH CLINIC, FORT RUCKER, AL 36362-5333
(334) 255-0443
Mailing address
BLDG 301 ANDREWS AVE, LYSTER ARMY HEALTH CLINIC, FORT RUCKER, AL 36362-5333
(334) 255-0443

Taxonomy

Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
E1693091
TX

Other

Enumeration date
05/14/2013
Last updated
05/14/2013
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