Individual
TREVOR LEE THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
1401 S 108TH ST, MILWAUKEE, WI 53214-4012
(414) 226-6619
Mailing address
1401 S 108TH ST, MILWAUKEE, WI 53214-4012
(414) 226-6619
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
WI
Other
Enumeration date
10/18/2024
Last updated
10/18/2024
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