Individual
MR. MARK KENNETH DOMKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RKT
Contact information
Practice address
765 SERENO DR, VALLEJO, CA 94589-2415
(707) 208-2081
Mailing address
18 STONECREEK DR, AMERICAN CANYON, CA 94503-3131
(707) 208-2081
Taxonomy
Speciality
Code
Description
License number
State
226300000X
Kinesiotherapist
Primary
—
—
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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