Individual
MRS. TRACIE TUE DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1650 COCHRANE CIR, FORT CARSON, CO 80913-4603
(719) 244-2286
Mailing address
5130 BARNSTORMERS AVE, COLORADO SPRINGS, CO 80911-1214
(808) 352-7258
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/27/2009
Last updated
12/06/2022
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