Individual
DOMINIC POLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
4984 N VIA CARINA, TUCSON, AZ 85704-1548
(520) 907-3863
Mailing address
4984 N VIA CARINA, TUCSON, AZ 85704-1548
(520) 907-3863
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-21792
AZ
Other
Enumeration date
05/02/2024
Last updated
05/02/2024
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