Individual
DOMINIQUE EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1517 W GARVEY AVE N, WEST COVINA, CA 91790-2138
(626) 962-6061
Mailing address
1856 NAVARRO AVE, PASADENA, CA 91103-1548
(626) 407-7321
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
10/20/2010
Last updated
10/20/2010
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