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Individual

THOMAS ANTHONY PIETROCARLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
2430C N GRANDVIEW BLVD, WAUKESHA, WI 53188-1605
(262) 542-3779
(262) 542-3954
Mailing address
2430C N GRANDVIEW BLVD, WAUKESHA, WI 53188-1605
(262) 542-3779
(262) 542-3954

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
408
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
43210100
WI
Enumeration date
08/18/2005
Last updated
03/21/2008
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