Deborah A Domino, APTA
Individual provider Active NPI Physical Therapy Assistant · Greenville, MS
NPI 1831661842 · NPPES record last updated Jan 2, 2019
Key facts
- NPI
- 1831661842
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- PTA6145 (MS)
- Practice address
- 1707 S Colorado St Ste a
Greenville, MS 38703-7275 - Phone
- (662) 335-8332
- Fax
- (662) 335-8852
- NPI assigned
- Jan 2, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA6145 | MS | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA6145 | MS | Yes |
Addresses
Primary practice location
1707 S Colorado St Ste a
Greenville, MS 38703-7275
Mailing address
1707 S Colorado St Ste a
Greenville, MS 38703-7275
Phone (662) 335-8332
Other providers in Greenville, MS
- Direct Transportation System, LLC
- Charles Randle Dishongh
- Divine Connection LLC
- Betty Taylor Dixon
- Dominick Trinca, M.D. PA
- Carol Cashion Doolittle
- Jeffery Samuel Doolittle
- Philip D Doolittle
- Sandra Dorman
- Harry L Dorsey
All providers in Greenville, MS · Physical Therapy Assistant in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 2, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.