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1508820010
DAVID J DOMINGUESE
WAUKESHA, WI
NPI
1508820010
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: WI 615-039)
Enumeration Date
2006-04-12
Last Update Date
2007-07-08
Business Address
-- DAVID J DOMINGUESE MS, ATC, CSCS
1111 DELAFIELD ST SUITE 120
WAUKESHA, WI 53188-3417
Phone number: 262-521-9762
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Mailing Address
-- DAVID J DOMINGUESE MS, ATC, CSCS
1711 ELDER ST APT. 103
WAUKESHA, WI 53188-3271
Phone number:
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