Individual
DR. DOMINIQUE SCUTELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234-4504
(210) 916-5732
Mailing address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
26199
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1395490555
DOD ID#
—
Enumeration date
10/03/2016
Last updated
12/08/2021
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