Individual
MR. DOMINIQUE JOSEPH BYRD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
1062 SPRINGWATER RD, KOKOMO, IN 46902-4899
(765) 776-6309
Mailing address
1062 SPRINGWATER RD, KOKOMO, IN 46902-4899
(765) 776-6309
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31002239A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31002239A
OCCUPATIONAL THERAPY
IN
Enumeration date
11/05/2007
Last updated
11/05/2007
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