Individual
DR. TIMOTHY WISETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
163 VETERANS DR EYE CLINIC, WHITE RIVER JUNCTION, VT 05009-0001
(320) 309-1016
Mailing address
1105 11TH ST SW, LITTLE FALLS, MN 56345-1917
(320) 309-1016
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
030.0133917
VT
Other
Enumeration date
05/22/2020
Last updated
05/22/2020
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