Individual
THOMAS J NICOLAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
305 ELAINES CT, DODGEVILLE, WI 53533-2103
(608) 930-4362
(608) 930-4366
Mailing address
305 ELAINES CT, DODGEVILLE, WI 53533-2103
(608) 930-4362
(608) 930-4366
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2383-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346293792
—
WI
Enumeration date
05/18/2006
Last updated
12/18/2020
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