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DR. CHRISTIE JO RUSSELL-VILLNOW O.D.
Vision Therapy >> Optometrist >> Eye and Vision Services ProvidersRegistrant NPI Number: 1538279575
Individual Registrant:DR. CHRISTIE JO RUSSELL-VILLNOW O.D.
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
15 E MINNESOTA ST SUITE 107 SAINT JOSEPH, MN 56374-4689 US
Tel: 320-433-4326 Fax: --
Tel: 320-433-4326 Fax: --
Contact information for business:
15 E MINNESOTA ST STE 107 SAINT JOSEPH, MN 56374-4691 US
Tel: 320-433-4326 Fax: --
Tel: 320-433-4326 Fax: --
Registration Information:
NPI: 1538279575
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 152WV0400X | Eye and Vision Services Providers Optometrist Vision Therapy | MN | 2981 |
| Y | 152W00000X | Eye and Vision Services Providers Optometrist | MN | 2981 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
