Individual
DAVID J DOMENICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
261 MAIN ST, NORTH SMITHFIELD, RI 02896-7919
(401) 356-4777
Mailing address
134 CAPORAL ST, CRANSTON, RI 02910-2618
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA01238
RI
Other
Enumeration date
03/28/2022
Last updated
03/28/2022
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