Individual
DOMINIQUE FREEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
439 CORTEZ RD W, BRADENTON, FL 34207-1544
(941) 284-6733
Mailing address
439 CORTEZ RD W, BRADENTON, FL 34207-1544
(941) 284-6733
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
CL1216296
FL
Other
Enumeration date
03/04/2019
Last updated
03/04/2019
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