Individual
MATTHEW THEIRL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
120 KELLER AVE N # 1034, AMERY, WI 54001-1034
(715) 268-9010
Mailing address
120 KELLER AVE N # 1034, AMERY, WI 54001-1034
(715) 268-9010
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3997-35
WI
Other
Enumeration date
05/27/2024
Last updated
05/27/2024
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