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1558056010
EMILY J DOMAILLE
SHEBOYGAN, WI
NPI
1558056010
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: WI 3070-19)
Enumeration Date
2023-04-10
Last Update Date
2023-04-10
Business Address
EMILY J DOMAILLE PTA
1125 N 13TH ST
SHEBOYGAN, WI 53081-3281
Phone number: 920-803-1617
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Mailing Address
EMILY J DOMAILLE PTA
1125 N 13TH ST
SHEBOYGAN, WI 53081-3281
Phone number: 920-803-1617
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