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Individual

THOMAS GEORGE BASTHOLM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1540 SAVANNAH RD, LEWES, DE 19958-1682
(302) 645-2020
(302) 645-2223
Mailing address
1540 SAVANNAH RD, LEWES, DE 19958-1682
(302) 645-2020
(302) 645-2223

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
DEI30001133
DE

Other

Enumeration date
11/15/2006
Last updated
07/08/2007
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