Individual
DR. KRISTINA M BORESPUPP
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
4455 HIGHWAY 169 N, PLYMOUTH, MN 55442-2897
(763) 551-0529
(763) 559-6010
Mailing address
3715 MARSH PT W, INDEPENDENCE, MN 55359-9820
(763) 479-3794
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2479
MN
Other
Enumeration date
03/24/2006
Last updated
07/08/2007
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