Individual
MARCUS THOMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
2900 GOLF RD, PEWAUKEE, WI 53072-5449
(608) 843-2634
Mailing address
1633 ALDORO DR, WAUKESHA, WI 53188-2227
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1687-39
WI
Other
Enumeration date
07/12/2019
Last updated
07/12/2019
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