Individual
CRISTIAN SHAVER DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5325 FARAON ST, SAINT JOSEPH, MO 64506-3488
(816) 749-4906
Mailing address
5325 FARAON ST, SAINT JOSEPH, MO 64506-3488
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/30/2024
Last updated
07/30/2024
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