Individual
ERIC JAMES THIEME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4115 CALUMET AVE, MANITOWOC, WI 54220-5400
(920) 684-5016
Mailing address
542 GILLETT ST, FOND DU LAC, WI 54935-4615
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17100
WI
Other
Enumeration date
10/26/2020
Last updated
10/26/2020
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