Individual
CARRIE DOMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
121 WARD CT, LAKEWOOD, CO 80228-5017
(303) 589-2796
Mailing address
121 WARD CT, LAKEWOOD, CO 80228-5017
(303) 589-2796
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA.0013654
CO
Other
Enumeration date
07/28/2015
Last updated
07/28/2015
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