Individual
MR. JORGE DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RRT, RCP
Contact information
Practice address
558 MALLOY ST, MANTENO, IL 60950-1742
(708) 527-6860
Mailing address
558 MALLOY ST, MANTENO, IL 60950-1742
(708) 527-6860
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
—
—
Other
Enumeration date
09/13/2013
Last updated
01/11/2015
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