Business Name
Physician First Name
Omar
Physician Middle Initial
Latimer
Physician Last Name
Dominique
Practice Name
Specialty
Family Practice
Office Designation
Primary
Address
9700 N. 91st Street
85258
85258
Suite
Suite A-115
City
Scottsdale
State
AZ
County
Maricopa
Business Phone Number
(480)770-3967
Business Fax
(602)888-8540
ASPA Effective Date
10/5/2020