Individual
DOMINIQUE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6702 RAVENWOOD DR, KETCHIKAN, AK 99901-9798
(907) 617-3765
Mailing address
6702 RAVENWOOD DR, KETCHIKAN, AK 99901-9798
(907) 617-3765
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
AK
Other
Enumeration date
08/02/2023
Last updated
08/02/2023
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