Individual
ANTONINO BOMMARITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1110 KEPLER DR, GREEN BAY, WI 54311-8306
(920) 288-5555
(920) 288-5550
Mailing address
1035 KEPLER DR, GREEN BAY, WI 54311-8320
(920) 490-9046
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5614
WI
363A00000X
Physician Assistant
—
—
Other
Enumeration date
09/22/2021
Last updated
09/26/2024
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