Individual
DAVID J DOMINGUESE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MS, ATC, CSCS
Contact information
Practice address
1111 DELAFIELD ST, SUITE 120, WAUKESHA, WI 53188-3417
(262) 521-9762
Mailing address
1711 ELDER ST, APT. 103, WAUKESHA, WI 53188-3271
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
615-039
WI
Other
Enumeration date
04/12/2006
Last updated
07/08/2007
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