Individual
THOMAS TESELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3029 PUTNAM GLEN PL, EAU CLAIRE, WI 54701-5071
(715) 839-0979
Mailing address
3029 PUTNAM GLEN PL, EAU CLAIRE, WI 54701-5071
(715) 839-0979
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1838
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38530100
—
WI
Enumeration date
01/11/2006
Last updated
01/24/2014
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