Mary Domine
NPI #1013626597 in Waite Park, Minnesota
Provider Information
- NPI Number
- 1013626597
- Entity Type
- Individual
- Name
- Mary Domine
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Specialist
- Enumeration Date
- Nov 23, 2022
- Last Updated
- Nov 23, 2022
Practice Location
- Address
- 423 GREAT OAK DR
- City
- Waite Park
- State
- Minnesota
- ZIP Code
- 56387-2507
- Phone
- (218) 287-4338
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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