Provider Demographics
NPI:1003039454
Name:CLAUSSEN, CHRISTA BETH (PT, ATC)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:BETH
Last Name:CLAUSSEN
Suffix:
Gender:F
Credentials:PT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15441 STACIE CT
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52002-9441
Mailing Address - Country:US
Mailing Address - Phone:563-582-3807
Mailing Address - Fax:
Practice Address - Street 1:444 N GRANDVIEW AVE
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-6331
Practice Address - Country:US
Practice Address - Phone:563-589-2497
Practice Address - Fax:563-557-2834
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA019052251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT0345Medicare ID - Type Unspecified