Provider Demographics
NPI:1508273830
Name:MCCARRELL, CHRISTINA RENEE (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:RENEE
Last Name:MCCARRELL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 S MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-2054
Mailing Address - Country:US
Mailing Address - Phone:517-278-3881
Mailing Address - Fax:
Practice Address - Street 1:35 S MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-2054
Practice Address - Country:US
Practice Address - Phone:517-278-3881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-18
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004848152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist