Individual
MR. FRANK T DOMINICK III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.P.
Contact information
Practice address
435 RIVER AVE, WILLIAMSPORT, PA 17701-3722
(877) 393-1414
(570) 743-5215
Mailing address
PO BOX 243, SUITE A, SHAMOKIN DAM, PA 17876-0243
(877) 393-1414
(570) 743-5215
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018173000003
—
PA
Enumeration date
02/25/2013
Last updated
02/25/2013
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