Individual provider · Type 1 NPI

Dominique Michele Waterbury

Driver · Fort Smith, AR

NPI number 1043773922 Active

Practice location

5400 Euper Ln
Fort Smith, AR 72903-3232

Call (479) 755-6601 Map

Mailing address

1900 Stillwater Dr
Jonesboro, AR 72404-9119

Specialties and licenses

TaxonomyCodeLicense
Driver Primary 172A00000X928984961 (AR)

Driver: A person employed to operate a motor vehicle as a carrier of persons or property.

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About NPI 1043773922

Dominique Michele Waterbury's National Provider Identifier is 1043773922, issued on Apr 9, 2019. The primary taxonomy on file is Driver (172A00000X), and the practice location is in Fort Smith, AR. The record was last updated on Apr 9, 2019.