Individual
MR. DOMINICK CHARLES ARETINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
516 NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
(505) 722-1226
Mailing address
PO BOX 1337, GALLUP, NM 87305-1337
(505) 722-1000
(505) 722-1226
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
831
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000R8788
—
NM
05
—
553629
—
AZ
Enumeration date
03/10/2006
Last updated
04/30/2008
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