Individual
DR. ANTHONY JACOB BRECHTELSBAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2825 HUNTERS TRL LOWR LEVEL, PORTAGE, WI 53901-3429
(608) 742-5522
(608) 745-3054
Mailing address
919 ESSEX PARK DR, JACKSON, MI 49203-3884
(517) 230-5547
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
3903
WI
152W00000X
Optometrist
Primary
4901005627
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760112973
—
WI
Enumeration date
06/13/2022
Last updated
01/05/2024
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