Wittrock, Kristina Nicole

Wittrock, Kristina Nicole is an individual health care provider with primary practice located at 2801 W Big Beaver Rd E132, Troy MI 48084-3243. She recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Pediatrics. Eye and Vision Services Providers / Optometrist is her primary health care specialty. Wittrock, Kristina Nicole can be contacted via phone (248) 643-6220.

Contact Information

Primary practice address
2801 W Big Beaver Rd E132 Troy MI 48084-3243
Phone: (248) 643-6220
Fax: (248) 643-4914
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 4901003786 Michigan
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X 4901003786 Michigan
Eye and Vision Services Providers / Pediatrics 152WP0200X 4901003786 Michigan

Profile Details

NPI number 1366430068
LBN Legal business name Wittrock, Kristina Nicole
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 7th, 2005
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366430068 NPPES
Michigan Other KW003876 BCBSM PIN

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