Individual provider · Type 1 NPI

Ivan Domenech

Physical Therapy Assistant · Southern Pines, NC

NPI number 1386972867 Active

Practice location

103 Gossman Rd
Southern Pines, NC 28387-2225

Call (910) 246-1158 Map

Mailing address

55 Blue Pine Dr
Spring Lake, NC 28390-9176

Specialties and licenses

TaxonomyCodeLicense
Physical Therapy Assistant Primary 225200000X4278 (NC)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1386972867

Ivan Domenech's National Provider Identifier is 1386972867, issued on Nov 23, 2009. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Southern Pines, NC. The record was last updated on Nov 23, 2009.