Individual
DR. DONALD JAMES DOMRATH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3415 CALUMET AVE, MANITOWOC, WI 54220-5427
(920) 683-2244
Mailing address
7711 HOMESTEAD RD, WHITELAW, WI 54247-9710
(920) 684-5127
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1317
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38567200
—
WI
Enumeration date
06/04/2006
Last updated
07/08/2007
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