Individual
JEFFREY J WILLIQUETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
232 S COURTNEY ST, RHINELANDER, WI 54501-3319
(715) 365-1515
(715) 365-1518
Mailing address
232 S COURTNEY ST, RHINELANDER, WI 54501-3319
(715) 365-1515
(715) 365-1518
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1845
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38518200
—
WI
Enumeration date
12/01/2006
Last updated
07/08/2007
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