Individual
TRACY CHRISTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
8081 WEDGEWOOD LN N, MAPLE GROVE, MN 55369-9412
(763) 416-3795
(763) 416-3769
Mailing address
16555 77TH CIR N, SUITE 6, MAPLE GROVE, MN 55311-3734
(210) 524-6663
(210) 524-6587
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2527
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
535916300
—
MN
Enumeration date
12/12/2006
Last updated
05/24/2016
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