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1841635109
THERESA MAE DOMINICK
LEAVENWORTH, KS
NPI
1841635109
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: KS 17-02236)
Enumeration Date
2013-04-30
Last Update Date
2013-04-30
Business Address
THERESA MAE DOMINICK OTR
1001 6TH AVE SUITE 240
LEAVENWORTH, KS 66048-3222
Phone number: 913-682-6103
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Mailing Address
THERESA MAE DOMINICK OTR
710 DEERFIELD ST
LEAVENWORTH, KS 66048-5541
Phone number: 913-775-3101
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