Individual
DR. CHRISTOPHER LEE WISTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1000 MINERAL POINT AVE, JANESVILLE, WI 53548-2940
(608) 756-6611
(608) 756-6177
Mailing address
1000 MINERAL POINT AVE, JANESVILLE, WI 53548-2940
(608) 756-6611
(608) 756-6177
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
5101017770
MI
207P00000X
Emergency Medicine Physician
Primary
57145-21
WI
Other
Enumeration date
07/28/2008
Last updated
08/22/2013
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