Individual
TRACY DOMINIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2142 N COVE BLVD, TOLEDO, OH 43606-3895
(419) 824-7345
(419) 824-7359
Mailing address
5855 MONROE ST, SYLVANIA, OH 43560-2269
(419) 824-7345
(419) 824-7359
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN.300695
OH
Other
Enumeration date
03/31/2015
Last updated
04/15/2015
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