Individual
DR. JUSTIN MARSHALL DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
(573) 596-1707
(573) 596-0435
Mailing address
3159 W HIGH POINT ST, SPRINGFIELD, MO 65810-7814
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2014026922
MO
Other
Enumeration date
01/30/2015
Last updated
01/30/2015
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