MEDICARE: DOMINIQUE FRENCH PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT6167	NM
2	225100000X	Physical Therapist	PT306094	CA
3	225100000X	Physical Therapist	6457	NV

General Provider Information

NPI Number	:	1245968213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOMINIQUE FRENCH PT, DPT

Provider Business Mailing Address
First Line	:	4050 SANTA FE DR
Second Line	:
City	:	FALLON
State	:	NV
Zip	:	89406-5246
Country	:	US
Telephone Number	:	847-815-3038
Fax Number	:

Provider Business Practice Location Address
First Line	:	4050 SANTA FE DR
Second Line	:
City	:	FALLON
State	:	NV
Zip	:	89406-5246
Country	:	US
Telephone Number	:	847-815-3038
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2022
Last Update Date	:	08/23/2024

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