Individual
JAY DOMINGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
92-530 PALAILAI ST, KAPOLEI, HI 96707-1038
(808) 221-8287
Mailing address
92-530 PALAILAI ST, KAPOLEI, HI 96707-1038
(808) 221-8287
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
04/20/2012
Last updated
04/20/2012
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