Individual
MS. ALISON JEAN DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1070 VINEHAVEN DR NE, CONCORD, NC 28025-2438
(704) 783-1840
(704) 783-1850
Mailing address
PO BOX 36351, CHARLOTTE, NC 28236-6351
(704) 377-5772
(704) 377-3389
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
102840
NC
Other
Enumeration date
04/19/2006
Last updated
01/06/2010
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