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1144516188
MARC DOMINIC BAZZANELLA
MADISON, WI
NPI
1144516188
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: WI 5218-26)
Enumeration Date
2011-06-28
Last Update Date
2012-07-30
Business Address
Mr. MARC DOMINIC BAZZANELLA
4502 MILWAUKEE ST
MADISON, WI 53714-2133
Phone number: 608-249-2137
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Mailing Address
Mr. MARC DOMINIC BAZZANELLA
29 PLEASANT OAK CT
OREGON, WI 53575-3225
Phone number: 831-278-0465
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