Individual
JOSE' D PANIAQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, ATC
Contact information
Practice address
400 EAST THIRD STREET, ESSENTIA HEALTH DULUTH CLINIC, DULUTH, MN 55805-1951
(218) 786-8364
Mailing address
400 EAST THIRD STREET, ESSENTIA HEALTH DULUTH CLINIC, DULUTH, MN 55805-1951
(218) 786-8364
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
1843
MN
363A00000X
Physician Assistant
Primary
11279
MN
363AS0400X
Surgical Physician Assistant
11279
MN
Other
Enumeration date
10/20/2006
Last updated
07/21/2016
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