Domingo Grullon Jr, DPT | |
19321 Mountain Hwy E Ste 100, Spanaway, WA 98387-8450 | |
(253) 846-8918 | |
(253) 846-8126 |
Full Name | Domingo Grullon Jr |
---|---|
Gender | Male |
Speciality | Physical Therapist |
Location | 19321 Mountain Hwy E Ste 100, Spanaway, Washington |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1720761570 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 40QA02192500 (New York) | Primary |
Provider Name | Multicare Health System |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1497766638 PECOS PAC ID: 7719899897 Enrollment ID: O20031105000760 |
Mailing Address | Practice Location Address |
---|---|
Domingo Grullon Jr, DPT 6050 Tacoma Mall Blvd Ste 300, Tacoma, WA 98409-6828 Ph: () - | Domingo Grullon Jr, DPT 19321 Mountain Hwy E Ste 100, Spanaway, WA 98387-8450 Ph: (253) 846-8918 |
Colton Kenneth Smith, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 19321 Mountain Hwy E Ste 100, Spanaway, WA 98387 Phone: 253-846-8918 | |
Miss Sejal J. Gajarawala, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 201 160th St S, Ste 301, Spanaway, WA 98387 Phone: 253-531-4100 Fax: 253-531-3795 | |
Justin Nicolas Robinson, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 19321 Mountain Hwy E Ste 100, Spanaway, WA 98387 Phone: 253-846-8918 | |
George Gay, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 19321 Mountain Hwy E Ste 100, Spanaway, WA 98387 Phone: 253-846-8918 | |
Signia A Ray, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 201 160th St S, Suite 301, Spanaway, WA 98387 Phone: 253-531-4100 Fax: 253-531-3795 | |
Michael Larkin Mulligan, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 19321 Mountain Hwy E Ste 100, Spanaway, WA 98387 Phone: 253-846-8918 | |
Jonathan Brown, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 19321 Mountain Hwy E Ste 100, Spanaway, WA 98387 Phone: 253-846-8618 |