Individual
DR. JACOB ANDREW WOLDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1087 W MASON ST, GREEN BAY, WI 54303-1859
(920) 499-3102
(920) 499-9636
Mailing address
1087 W MASON ST, GREEN BAY, WI 54303-1859
(920) 499-3102
(920) 499-9636
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
002598
IA
152W00000X
Optometrist
3615
WI
152W00000X
Optometrist
Primary
692
SD
Other
Enumeration date
08/09/2012
Last updated
12/22/2021
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