Individual
DANIEL SCOTT DOMROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2440 NW PROFESSIONAL DR, TIMBER HILL FOOT CLINIC DANIEL S DOMROSE DPM, CORVALLIS, OR 97330
(541) 754-9665
(541) 758-5706
Mailing address
2440 NW PROFESSIONAL DR, TIMBER HILL FOOT CLINIC DANIEL S DOMROSE DPM, CORVALLIS, OR 97330
(541) 754-9665
(541) 758-5706
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DP00264
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
073119
—
OR
01
—
DP00264
STATE LICENSE
OR
Enumeration date
01/22/2007
Last updated
07/08/2007
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