Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 3151-35 | WI |
NPI | 1013145952 |
---|---|
Provider Name | Dr. Christine Ann Ward |
First Address | Monroe, WI 53566-1063 |
Second Address | Monroe, WI 53566-1063 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2009 |
Last Update Date | 26/03/2015 |