Denise Douglass

NPI #1134752934 in Saint Croix Falls, Wisconsin

Provider Information

NPI Number: 1134752934
Entity Type: Individual
Name: Denise Douglass
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: Feb 20, 2020
Last Updated: Feb 20, 2020

Practice Location

Address: 31 NORTHSTAR LN
City: Saint Croix Falls
State: Wisconsin
ZIP Code: 54024-9005
Phone: (715) 441-2628

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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