Organization
DOMINGA'S THERAPY SERVICES PTR PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY DALE PALMER MOT (VICE PRESIDENT)
(954) 581-5492
Entity
Organization
Contact information
Practice address
1950 SW 37TH AVE, FORT LAUDERDALE, FL 33312-4220
(954) 581-5492
Mailing address
1950 SW 37TH AVE, FORT LAUDERDALE, FL 33312-4220
(954) 581-5492
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
P01000084214
FL
Other
Enumeration date
10/11/2007
Last updated
10/11/2007
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