Individual
DR. STEVEN TICKNOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3621 MARKET LN, KENOSHA, WI 53144-1553
(262) 658-8119
(262) 658-8261
Mailing address
568 WOODCREST DR, MUNDELEIN, IL 60060-1525
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3810-35
WI
Other
Enumeration date
05/16/2022
Last updated
09/04/2024
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