Thomas G Peterson Od Sc

NPI 1033197397 - Optometrist - 152W00000X

NPI Details
NPI 1033197397
Enumeration Date 01/06/2006
Last Updated 04/15/2008
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name THOMAS G THOMAS
Position PRESIDENT
Phone (715) 526-3163
Fax (715) 526-4019
Practice Location
115 ALPINE CT
SHAWANO WI, 54166-0513, US
Phone (715) 526-3163
Fax (715) 526-4019
Business Location
PO BOX 513
SHAWANO WI, 54166-0513, US
Phone (715) 526-3163
Fax (715) 526-4019
Toxanomy
Taxonomy Code 152W00000X
License State Wisconsin
License Number 2324
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According to our database, Thomas G Peterson Od Sc NPI is 1033197397, taxonomy code is 152W00000X and license number is 2324, license state is located at Wisconsin. Thomas G Peterson Od Sc physically located at 115 Alpine Ct, Shawano WI, 54166-0513. NPI Number 1033115704 has the healthcare provider type.

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1033197397 NPI number is provided on an as is basis without warranty of any kind. 1033197397 is maintained by the National Plan & Provider Enumeration System. The contents of Thomas G Peterson Od Sc are for informational purposes only.