The holder whose full name is Fernandez, Manicar Domantay,come from Granger IN,hold the Physical Therapist license(NO.05006025A) which status is Active.
| Name | Fernandez, Manicar Domantay |
|---|---|
| License Number | 05006025A |
| License Type | Physical Therapist |
| License Status | Active |
| City | Granger |
| State | IN |