Individual
DOMINIC MORALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4801 OLYMPIA PARK PLZ STE 3000, LOUISVILLE, KY 40241-0001
(314) 488-7911
Mailing address
4801 OLYMPIA PARK PLZ STE 3000, LOUISVILLE, KY 40241-0001
(314) 488-7911
Taxonomy
Speciality
Code
Description
License number
State
2083S0010X
Sports Medicine (Preventive Medicine) Physician
AT1974
KY
2255A2300X
Athletic Trainer
Primary
AT1974
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT1974
KENTUCKY BOARD OF MEDICAL LICENSURE
KY
Enumeration date
08/07/2014
Last updated
09/28/2023
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