Individual
HOLLY DENISE DOMORAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
406 S MAIN ST, WINNSBORO, TX 75494-3226
(903) 342-6792
Mailing address
620 TOWN OAKS CIR, KILGORE, TX 75662-2238
(903) 237-8611
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2051331
TX
Other
Enumeration date
05/07/2018
Last updated
05/07/2018
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