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Individual

MRS. SHALYNN DOMINGUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
4119 NW BARRY RD, KANSAS CITY, MO 64154-1100
(816) 452-4488
Mailing address
112 SHERMAN ST, WATHENA, KS 66090-4114
(785) 243-0054

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
KS
225200000X
Physical Therapy Assistant
Primary
MO

Other

Enumeration date
09/06/2023
Last updated
09/06/2023
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