Individual
DR. THADDEUS DANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1244 E GREEN BAY ST, OPTICAL DEPT, SHAWANO, WI 54166-2208
(715) 526-2376
(715) 526-9651
Mailing address
1244 E GREEN BAY ST, SHAWANO, WI 54166-2208
(715) 526-2376
(715) 526-9651
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2359
WI
152W00000X
Optometrist
2396
CO
Other
Enumeration date
03/14/2007
Last updated
03/19/2025
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