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Individual

JEFFREY E CHRISTIANSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1837 LAFAYETTE ST, JANESVILLE, WI 53546-2860
(608) 756-0728
(608) 756-0782
Mailing address
16800 WEST CLEVELAND AVE, NEW BERLIN, WI 53151-3533
(262) 432-2005

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2575-035
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38605400
WI
01
WI2575
EYEMED VISION NO.
Enumeration date
08/26/2006
Last updated
12/21/2007
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