Individual
DOMONIQUE GOMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
34921 US HIGHWAY 19 N, PALM HARBOR, FL 34684-1969
(800) 251-8998
Mailing address
34921 US HIGHWAY 19 N, PALM HARBOR, FL 34684-1969
(800) 251-8998
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
PTA24533
FL
Other
Enumeration date
01/30/2014
Last updated
01/30/2014
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