Individual
DR. CHRISTINA MARIE PETROU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
7040 N PORT WASHINGTON RD, SUITE 420, GLENDALE, WI 53217-3885
(414) 247-2020
Mailing address
1530 E GOODRICH LN, FOX POINT, WI 53217-2951
(414) 839-8379
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2387-035
WI
152WC0802X
Corneal and Contact Management Optometrist
2387
WI
152WL0500X
Low Vision Rehabilitation Optometrist
2387-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2718
PTAN
WI
05
—
38575400
—
WI
Enumeration date
06/04/2006
Last updated
06/21/2012
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