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Individual

DOMINIQUE D SHIELDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1526 S FRONT ST, PHILADELPHIA, PA 19147-5518
(215) 463-2000
(215) 463-2200
Mailing address
1526 S FRONT ST, PHILADELPHIA, PA 19147-5518
(215) 463-2000
(215) 463-2200

Taxonomy

Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary

Other

Enumeration date
09/19/2009
Last updated
09/19/2009
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