Individual
GENEVIEVE OBRIEN DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA, CMT
Contact information
Practice address
105 S FOREST RD STE C, SONORA, CA 95370-4895
(714) 330-8290
(808) 242-4762
Mailing address
PO BOX 1674, JAMESTOWN, CA 95327-1674
(714) 330-8290
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
—
—
225700000X
Massage Therapist
Primary
75153
CA
Other
Enumeration date
04/17/2008
Last updated
12/18/2023
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