Individual
MR. DOMINIC L MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MED, ATC, LAT
Contact information
Practice address
128 UCA PRINCE CTR, 201 DONAGHEY, CONWAY, AR 72035-0001
(501) 852-7748
Mailing address
2270 MEADOWLAKE RD, APT 808, CONWAY, AR 72032-2562
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT 386
AR
Other
Enumeration date
01/05/2007
Last updated
07/08/2007
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