Individual
DR. JASON KEITH DOMENICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
905 W KEEGANS WAY, GREENSBURG, IN 47240-3409
(812) 663-7640
(812) 662-6356
Mailing address
905 W KEEGANS WAY, GREENSBURG, IN 47240-3409
(812) 663-7640
(812) 662-6356
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
08002663A
IN
111N00000X
Chiropractor
Primary
4073
OH
111N00000X
Chiropractor
81000133A
IN
111N00000X
Chiropractor
DC010243
PA
Other
Enumeration date
05/19/2010
Last updated
01/29/2014
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