Individual provider · NPI-1

Olma Dominguez, 1184

Rehabilitation Practitioner · Albuquerque, NM

NPI number1508980145
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1508980145
Entity type
Individual (NPI-1)
Name
Ms. Olma Dominguez
Credential
1184
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 19, 2007
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225400000X Rehabilitation Practitioner1184NMYes

Practice location

1111 Menaul Blvd Ne
Albuquerque, NM 87107-1614

Phone 505-255-5501 · Fax 505-255-9971

Mailing address

1111 Menaul Blvd Ne
Albuquerque, NM 87107-1614

Phone 505-255-5501 · Fax 505-255-9971

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