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Individual

MS. DEBRA JOAN SANFILIPPO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
9900 KAWAGA RD, MINOCQUA, WI 54548-9107
(715) 356-8000
Mailing address
9900 KAWAGA RD, MINOCQUA, WI 54548-9107
(715) 358-9730

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
296023
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42939600
WI
Enumeration date
06/27/2006
Last updated
07/09/2007
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