Individual
ZACHARY LEE THOMASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3003 W GOOD HOPE RD, GLENDALE, WI 53209-2042
(414) 352-3100
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
046011563
IL
152W00000X
Optometrist
Primary
3811
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100214450
—
WI
Enumeration date
08/10/2021
Last updated
05/15/2026
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