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1962914580
MICHAEL WILLIAM DOMINISSE
FOLSOM, CA
NPI
1962914580
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2017-11-05
Last Update Date
2017-11-05
Business Address
Mr. MICHAEL WILLIAM DOMINISSE PA
111 ALVASTON CT
FOLSOM, CA 95630-8614
Phone number: 916-402-7388
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Mailing Address
Mr. MICHAEL WILLIAM DOMINISSE PA
111 ALVASTON CT
FOLSOM, CA 95630-8614
Phone number: 916-402-7388
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