Individual
THOMAS N THORSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
12203 CORPORATE PKWY, MEQUON, WI 53092-3388
(262) 387-8200
(262) 387-8239
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
68796
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100075226
—
WI
Enumeration date
03/29/2016
Last updated
08/14/2024
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