Individual
DR. CHARLES DOUGLAS STINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
4009 COMMUNITY CENTER DR, WESTON, WI 54476-4139
(715) 241-2020
(715) 241-9827
Mailing address
4009 COMMUNITY CENTER DR, WESTON, WI 54476-4139
(715) 241-2020
(715) 241-9827
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1909035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38521100
—
WI
Enumeration date
12/28/2005
Last updated
02/19/2016
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