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1952097065
IAN J DOMINGUEZ
WARREN, MI
NPI
1952097065
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-04-12
Last Update Date
2023-04-12
Business Address
IAN J DOMINGUEZ DO
11885 E 12 MILE RD STE 300A
WARREN, MI 48093-3467
Phone number: 586-573-7470
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Mailing Address
IAN J DOMINGUEZ DO
11885 E 12 MILE RD STE 300A
WARREN, MI 48093-3467
Phone number: 586-573-7470
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