Provider Demographics
NPI:1033380654
Name:PETRIE, CHRISTOPHER PATRICK (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:PATRICK
Last Name:PETRIE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5923 MILLERS CIR SE
Mailing Address - Street 2:
Mailing Address - City:PRIOR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55372-2032
Mailing Address - Country:US
Mailing Address - Phone:940-367-0840
Mailing Address - Fax:
Practice Address - Street 1:2501 W 84TH ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55431-1599
Practice Address - Country:US
Practice Address - Phone:940-367-0840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-24
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10866111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor