Individual
DOMINGO DIAZ-VAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6728 RAVEN CRST, LIBERTY TWP, OH 45011-9235
(937) 270-7163
Mailing address
1740 E STROOP RD UNIT 292633, KETTERING, OH 45429-7537
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
11/12/2020
Last updated
11/17/2020
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