person
Ethan Ross Dominguez
Student in an Organized Health Care Education/Training Program in Fort Smith, Arkansas
NPI 1548900574

Ethan Ross Dominguez is a Student in an Organized Health Care Education/Training Program based in Fort Smith, AR. Ethan Ross Dominguez practices in Fort Smith, AR. The NPI Number for Ethan Ross Dominguez is 1548900574 and holds a License No. (Arkansas).

The current practice location address for Ethan Ross Dominguez is 612 S 12Th St, Fort Smith, AR and can be reached out via phone at 479-785-2431.

Location: 612 S 12Th St, Fort Smith, AR, 72901-4702
person
Provider Profile Details
NPI Number
1548900574
Provider Name
Ethan Ross Dominguez
Credential
Provider Entity Type
Individual
Gender
Male
Address
612 S 12Th St, Fort Smith, AR, 72901-4702
Phone Number
479-785-2431
Fax Number
Provider Enumeration Date
03/29/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
612 S 12Th St
City
State
Zip
72901-4702
Phone Number
479-785-2431
Fax Number
person
Provider Business Mailing Address Details
Address
612 S 12Th St
City
State
Zip
72901-4702
Phone Number
479-785-2431
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
(Arkansas)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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