DOMINIQUE WATERBURY

Driver

Active Individual
NPI: 1043773922

Practice Address

5400 EUPER LN
Fort Smith, AR 72903

Phone: (479) 755-6601

Specialties

Specialty Code Primary License
Driver 172A00000X Yes 928984961 (AR)

Frequently Asked Questions

NPI 1043773922 is the National Provider Identifier for DOMINIQUE WATERBURY, a Driver provider located in Fort Smith, AR. This NPI was enumerated on April 9, 2019.
DOMINIQUE WATERBURY practices at 5400 EUPER LN, Fort Smith, AR 72903.

Quick Facts

NPI
1043773922
Type
Individual
Enumerated
Apr 9, 2019
Last Updated
Apr 9, 2019

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