DAVID J DOMIN MD PC
Medical Practice at Central Ave, Phoenix, AZ

License number
Arizona 30234
Category
Medical Practice
Type
Specialist
Owner
Name: DR. DAVID J DOMIN MD
Title: PRESIDENT
Phone: (602) 264-1395
Address
Address
5133 N Central Ave STE 200, Phoenix, AZ 85012
National Provider ID: 1033225214
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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DAVID J. DOMIN, M.D., PC

Phoenix, AZ  -  Missoula, MT

Registration:
Nov 8, 2002
Addresses:
5133 N Central Ave SUITE 200, Phoenix, AZ 85012 (Physical)
St Peter Law Office, Missoula, MT 59808 (Foreign)
State ID:
F-1048520-1
Expiration:
Perpetual
Directors:
David J Domin (President/ceo), PO Box 37615, Phoenix, AZ 85069 (Physical),Susan D Domin (Secretary), PO Box 37615, Phoenix, AZ 85069 (Physical),David J Domin Md (Director), PO Box 37615, Phoenix, AZ 85069 (Physical)
Business type:
Health Care

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