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General NPI Number Information
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NPI Number | 1407138928
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Entity Type | Organization
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Legal Business Name | SANDRA DOMAN DC LLC
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Dates
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Enumeration Date | 09/10/2011
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Last Update Date | 09/10/2011
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Provider Practice Location Address
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Address Line | 18205 BISCAYNE BLVD SUITE 2217
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City | AVENTURA
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State | FL
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Zip | 33160-2106
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Country | US
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Telephone | 305-932-2218
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Fax | 305-438-7977
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Provider Business Mailing Address
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Address Line | 18205 BISCAYNE BLVD SUITE 2217
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City | AVENTURA
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State | FL
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Zip | 33160-2106
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Country | US
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Telephone | 305-932-2218
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Fax | 305-438-7977
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Authorized Official
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Title or Position | OWNER
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Name | DR. SANDRA LISA DOMAN
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Credential | DC
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Telephone | 301-580-9588
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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 |
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License Number State |
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