Individual
MRS. DEANNA DOMNISCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2307 S DALE MABRY HWY STE F, TAMPA, FL 33629-6322
(813) 374-9508
Mailing address
4711 S HIMES AVE APT 801, TAMPA, FL 33611-2622
(716) 696-0212
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2305208347
VA
225100000X
Physical Therapist
Primary
PT38897
FL
225100000X
Physical Therapist
PT871510
DC
Other
Enumeration date
11/04/2013
Last updated
07/11/2022
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