Individual
CRISTELLE ELISE BOOTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
11091 ULYSSES ST NE STE 300, BLAINE, MN 55434-4238
(952) 888-5800
(952) 567-6156
Mailing address
9801 DUPONT AVE S, STE 425, BLOOMINGTON, MN 55431-3873
(952) 888-5800
(952) 567-6176
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
18004193A
IN
152W00000X
Optometrist
Primary
3712
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18004193A
INDIANA STATE LICENSE
IN
Enumeration date
08/28/2019
Last updated
08/04/2023
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