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General NPI Number Information
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NPI Number | 1265587034
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Entity Type | Organization
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Legal Business Name | JOSEPH M. THALLEMER, O.D., P.C.
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 09/03/2009
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Provider Practice Location Address
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Address Line | 3301 E CENTER STREET EXT
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City | WARSAW
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State | IN
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Zip | 46582-3909
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Country | US
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Telephone | 574-269-3828
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Fax | 574-269-3848
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Provider Business Mailing Address
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Address Line | 3301 E CENTER STREET EXT
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City | WARSAW
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State | IN
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Zip | 46582-3909
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Country | US
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Telephone | 574-269-3828
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Fax | 574-269-3848
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH MICHAEL THALLEMER
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Credential | O.D.
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Telephone | 574-269-3828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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