Provider Demographics
NPI:1285083543
Name:ULRICH, CHRISTINA (OD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:ULRICH
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 1:196 THF BLVD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-1141
Mailing Address - Country:US
Mailing Address - Phone:636-728-0369
Mailing Address - Fax:636-728-0371
Practice Address - Street 1:196 THF BLVD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63005-1141
Practice Address - Country:US
Practice Address - Phone:636-728-0369
Practice Address - Fax:636-728-0371
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016015965152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist