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General NPI Number Information
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NPI Number | 1053444034
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Entity Type | Individual
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Provider Name | VICTOR A DOMINGUEZ SIERRA DC
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Gender | Male
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | VILLA UNIVERSITARIA CALLE 13 BC 12
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City | HUMACAO
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State | PR
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Zip | 00791
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Country | US
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Telephone | 787-412-1335
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Fax |
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Provider Business Mailing Address
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Address Line | 108 DIAMANTE PASEO SANTA BARBARA
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City | GURABO
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State | PR
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Zip | 00778
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Country | US
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Telephone | 787-412-1335
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 246
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License Number State | PR
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