Individual
STEVEN CHARLES DOMAGALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
3090 LAKESIDE DR, WILLOW RIVER, MN 55795-3327
(507) 304-1689
Mailing address
3090 LAKESIDE DR, WILLOW RIVER, MN 55795-3327
(507) 304-1689
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R149110-0
MN
Other
Enumeration date
10/19/2011
Last updated
06/06/2013
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