Individual
DOMINIC FASOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
600 CHESTNUT AVE, ALTOONA, PA 16601-4802
(814) 943-0545
Mailing address
516 WINDSOR DR, ALTOONA, PA 16601-9663
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP040500L
PA
Other
Enumeration date
12/11/2019
Last updated
12/11/2019
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