Individual
DOMINIC TOMCZYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
N84W16889 MENOMONEE AVE, MENOMONEE FALLS, WI 53051
(262) 251-7500
(262) 532-1396
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(414) 389-2338
(414) 385-8987
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
14650-024
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100089546
—
WI
05
—
14650-024
—
WI
Enumeration date
06/16/2019
Last updated
09/10/2019
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