Individual
DOMINIQUE GOMEZ MODESTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2 STONE HARBOR BLVD, CAPE MAY COURT HOUSE, NJ 08210-2138
(609) 463-2000
Mailing address
258 CHURCHILL DR, EGG HARBOR TOWNSHIP, NJ 08234-8002
(609) 653-2798
(609) 653-2798
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00964000
NJ
Other
Enumeration date
04/04/2007
Last updated
07/08/2007
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