Individual
GERALD O THEUNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
128 N TRATT ST, WHITEWATER, WI 53190-1212
(262) 473-4514
(262) 473-3161
Mailing address
128 N TRATT ST, WHITEWATER, WI 53190-1212
(262) 473-4514
(262) 473-3161
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1557-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700830536
—
WI
Enumeration date
05/19/2006
Last updated
12/29/2020
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