Individual
RAYMOND M GOGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
515 N 17TH AVE, WAUSAU, WI 54401-2910
(715) 848-1246
(715) 842-1660
Mailing address
515 N 17TH AVE, WAUSAU, WI 54401-2910
(715) 848-1246
(715) 842-1660
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1535
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38502100
—
WI
05
—
38704700
—
WI
05
—
38707200
—
WI
Enumeration date
02/02/2006
Last updated
01/28/2009
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