Provider Demographics
NPI:1871909788
Name:REXFORD, CHRISTINA (OD)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:REXFORD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:MARSMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3579 ALPINE AVE NW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49544-1635
Mailing Address - Country:US
Mailing Address - Phone:616-432-3591
Mailing Address - Fax:616-432-3597
Practice Address - Street 1:3579 ALPINE AVE NW
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49544-1635
Practice Address - Country:US
Practice Address - Phone:616-432-3591
Practice Address - Fax:616-432-3597
Is Sole Proprietor?:No
Enumeration Date:2014-07-11
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004847152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist