Individual
ANDREA MARIE DOMINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4510 MEDICAL CENTER DR STE 109, MCKINNEY, TX 75069-1624
(972) 547-8081
Mailing address
4510 MEDICAL CENTER DR STE 109, MCKINNEY, TX 75069-1624
(972) 547-8081
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1108264
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8T4506
BCBS
TX
Enumeration date
09/25/2006
Last updated
05/21/2021
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