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Individual

DR. CHRISTEN MICHELE RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
7051 SOUTHPOINT PKWY S FL 3R, JACKSONVILLE, FL 32216-8713
(904) 398-2720
(904) 483-5650
Mailing address
7051 SOUTHPOINT PKWY S FL 3R, JACKSONVILLE, FL 32216-8713
(904) 398-2720
(904) 483-5650

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC 4460
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OPC4460
FLORIDA LICENSE
FL
01
OPT002558
GEORGIA LICENSE
GA
Enumeration date
08/17/2009
Last updated
03/07/2023
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