Henry Domen JR.

NPI #1609992593 in La Plata, Maryland

Provider Information

NPI Number: 1609992593
Entity Type: Individual
Name: Henry Domen JR.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapy Assistant
Enumeration Date: Mar 22, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 107 S WILTSHIRE CT
City: La Plata
State: Maryland
ZIP Code: 20646-3515
Phone: (301) 932-1840

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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