Individual
DR. JEFFRY S GOLDTHORPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
130 HENRY DRIVE, PORTAGE, WI 53901-1105
(608) 742-7050
Mailing address
130 HENRY DR, PORTAGE, WI 53901-1105
(608) 742-7050
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
WI2720
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38604100
—
WI
Enumeration date
06/28/2006
Last updated
07/08/2007
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