Mr. Mark Kenneth Domke
Kinesiotherapist
765 Sereno Dr
Vallejo
, California 94589-2415
Mr. Mark Kenneth Domke
Kinesiotherapist
765 Sereno Dr
Vallejo
, California 94589-2415
(707) 208-2081
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About
Features
Specialties
- Kinesiotherapist
Languages spoken
- English
Location
First Address
- Mr. Mark Kenneth Domke
- 18 Stonecreek Dr
- American Canyon, CA
- Zip : 94503-3131
- Phone : (707) 208-2081
Second Address
- Mr. Mark Kenneth Domke
- 765 Sereno Dr
- Vallejo, CA
- Zip : 94589-2415
- Phone : (707) 208-2081
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 226300000X | Kinesiotherapist |
National Provider Identifier
| NPI | 1396967600 |
|---|---|
| Provider Name | Mr. Mark Kenneth Domke |
| First Address | American Canyon, CA 94503-3131 |
| Second Address | Vallejo, CA 94589-2415 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/05/2007 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.