Individual
DOMINIQUE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
625 WALNUT ST, MCKEESPORT, PA 15132-2806
(412) 673-5005
Mailing address
310 FISK ST, PITTSBURGH, PA 15201-1708
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE011554
PA
Other
Enumeration date
08/02/2018
Last updated
03/25/2021
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