Individual
CHRISTINE DOMINGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
81 CENTRAL AVE, WAILUKU, HI 96793-1723
(808) 285-7803
Mailing address
2072 KAMAILE ST, WAILUKU, HI 96793-5457
(808) 285-7803
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
EL-45
HI
Other
Enumeration date
04/11/2020
Last updated
04/11/2020
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