IVAN DOMENECH

SOUTHERN PINES, NC
NPI1386972867
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: NC  4278)
Enumeration Date2009-11-23
Last Update Date2009-11-23
Business Address
-- IVAN DOMENECH
103 GOSSMAN RD
SOUTHERN PINES, NC 28387-2225
Phone number: 910-246-1158
Mailing Address
-- IVAN DOMENECH
55 BLUE PINE DR
SPRING LAKE, NC 28390-9176
Phone number: 910-814-2726
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