Individual
DOMINIC JACOB CAMPOS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
916 E HILL AVE, GALLUP, NM 87301-5572
(505) 721-6513
Mailing address
916 E HILL AVE, GALLUP, NM 87301-5572
(505) 721-6513
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-2023-0006
NM
Other
Enumeration date
08/01/2023
Last updated
08/01/2023
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