Individual
TARA RENEE DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
10400 W 103RD ST STE 22, OVERLAND PARK, KS 66214-2664
(913) 322-4000
Mailing address
10400 W 103RD ST, STE 22, OVERLAND PARK, KS 66214-2664
(913) 322-4000
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2008024821
MO
2251X0800X
Orthopedic Physical Therapist
Primary
1105159
KS
Other
Enumeration date
08/19/2008
Last updated
12/27/2019
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