Individual
MR. DOMINIC LEE DI MANNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC-R
Contact information
Practice address
13253 W UTAH CIR, LAKEWOOD, CO 80228-4227
(303) 912-4530
Mailing address
13253 W UTAH CIR, LAKEWOOD, CO 80228-4227
(303) 912-4530
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
666
CO
Other
Enumeration date
08/15/2013
Last updated
08/15/2013
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