Individual
GREGORIO DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
HHP
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
46608
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46608
CERTIFIED MASSAGE THERAPIST
CA
Enumeration date
11/02/2015
Last updated
11/02/2015
Update your record
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