Ivan Dominguez, SPT ATC LAT Valid NPI

Individual provider · Physical Therapist · Fort Sam Houston, TX

NPI

1083065130

Type

Individual (Type 1)

Primary specialty

Physical Therapist

Specialty group

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy code

225100000X

License number

1335011 (TX)

Sex

Male

Sole proprietor

Yes

Enumerated

2016-06-29

Last updated

2023-11-02