Individual
MRS. STEPHANIE S DOMINGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
155 HAMAKUA DR STE B, KAILUA, HI 96734-2849
(808) 261-8931
Mailing address
155 HAMAKUA DR STE B, KAILUA, HI 96734-2849
(808) 261-8931
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
808
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
808
PHYSICAL THERAPIST
HI
Enumeration date
11/02/2009
Last updated
11/02/2009
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