Provider Demographics
NPI:1255464848
Name:BRISSON, CHRISTINE ANNE (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:ANNE
Last Name:BRISSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:1162 RIDGEWAY DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1771
Mailing Address - Country:US
Mailing Address - Phone:248-652-9123
Mailing Address - Fax:248-673-4428
Practice Address - Street 1:4470 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-1222
Practice Address - Country:US
Practice Address - Phone:248-674-4065
Practice Address - Fax:248-673-4428
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003349152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist