| Doctor Name: | JANE A DOMROESE |
| NPI Number: | 1447286869 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | 1412 |
| Business Practice Address: | 407 S Main St Viroqua, WI - 546652057 |
| Business Phone Number: | 6086373195 |
| Business Fax Number: | |
| Mailing Address: | 1836 South Ave, LA CROSSE |
| State: | WI |
| Postal Code: | 546015429 |
| Phone Number: | 6087827300 |
| Fax Number: | |
| NPI Enumeration Date: | 06/25/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 1412 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |