Individual
EMILY J DOMAILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1125 N 13TH ST, SHEBOYGAN, WI 53081-3281
(920) 803-1617
(920) 803-1622
Mailing address
1125 N 13TH ST, SHEBOYGAN, WI 53081-3281
(920) 803-1617
(920) 803-1622
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3070-19
WI
Other
Enumeration date
04/10/2023
Last updated
04/10/2023
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