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1417110966
ELENA DOMATOV
LEXINGTON, KY
NPI
1417110966
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2008-07-04
Last Update Date
2008-07-04
Business Address
-- ELENA DOMATOV
3769 WINTHROP DR
LEXINGTON, KY 40514-1748
Phone number: 859-971-1711
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Mailing Address
-- ELENA DOMATOV
3769 WINTHROP DR
LEXINGTON, KY 40514-1748
Phone number:
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