Individual
ELENA DOMATOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3769 WINTHROP DR, LEXINGTON, KY 40514-1748
(859) 971-1711
Mailing address
3769 WINTHROP DR, LEXINGTON, KY 40514-1748
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
KY
Other
Enumeration date
07/04/2008
Last updated
07/04/2008
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