Individual
ERICA DOMALECZNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MMS, PA-C
Contact information
Practice address
1533 DOUGLAS RD, WICKLIFFE, OH 44092-1001
(937) 344-7911
Mailing address
1533 DOUGLAS RD, WICKLIFFE, OH 44092-1001
(937) 344-7911
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.005116RX
OH
Other
Enumeration date
06/20/2017
Last updated
06/20/2017
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