Individual
ASHLEY DOMMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
334 MAIN ST, DICKSON CITY, PA 18519-1769
(570) 307-1767
(570) 307-1770
Mailing address
334 MAIN ST, DICKSON CITY, PA 18519-1769
(570) 307-1767
(570) 307-1770
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA055726
PA
363AS0400X
Surgical Physician Assistant
MA055726
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1106595
NCCPA ID
—
01
—
MA055726
PA LICENSE NUMBER
PA
Enumeration date
09/24/2012
Last updated
09/24/2012
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