Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ivan Domenech

Individual provider Physical Therapy Assistant · NPI 1386972867

Ivan Domenech is a Physical Therapy Assistant in Southern Pines, North Carolina. Licensed in North Carolina. Registered with an NPI since 2009.

Licensed in
NC
In the registry since
2009

Practice location Address checks out

103 Gossman Rd
Southern Pines, NC 28387-2225
Phone: (910) 246-1158
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 4278 (NC)

Record details

NPI number1386972867
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 23, 2009
Last updated in NPPESNovember 23, 2009

Other providers in Southern Pines