Individual
DR. TERRY LYNN CHRISTOPHERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
341 KELLER AVE N, AMERY, WI 54001-1037
(715) 268-2004
(715) 268-5432
Mailing address
PO BOX 76, AMERY, WI 54001-0076
(715) 268-2004
(715) 268-5432
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1530035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38564500
—
WI
01
—
92262CH
BCBS MN COM INS CO
MN
Enumeration date
03/18/2006
Last updated
10/28/2011
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