Individual
ANTHONY JOSEPH DOMZALSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1638 OWEN DR, FAYETTEVILLE, NC 28304-3424
(910) 615-4000
Mailing address
38 TAHOE CIR, SANFORD, NC 27332-0123
(919) 721-3694
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-06970
NC
Other
Enumeration date
01/16/2017
Last updated
01/16/2017
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