Provider Demographics
NPI:1831148873
Name:GEER, THOMAS ALLEN (LPN)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ALLEN
Last Name:GEER
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 62
Mailing Address - Street 2:
Mailing Address - City:DODGEVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53533-0062
Mailing Address - Country:US
Mailing Address - Phone:608-574-6299
Mailing Address - Fax:
Practice Address - Street 1:225 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:DODGEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53533-1207
Practice Address - Country:US
Practice Address - Phone:608-937-0318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38314800Medicaid