Individual
PETER THAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12714 W HAMPTON AVE STE F, BUTLER, WI 53007-1640
(414) 758-3287
Mailing address
W143N5009 BROOK FALLS DR, MENOMONEE FALLS, WI 53051-6987
(414) 758-3287
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
05/06/2021
Last updated
05/06/2021
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