Provider Demographics
NPI:1083861967
Name:ERICKSEN, CHRISTIAN K (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:K
Last Name:ERICKSEN
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 1:124 N 10TH ST
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74021-2318
Mailing Address - Country:US
Mailing Address - Phone:918-850-4176
Mailing Address - Fax:918-623-1600
Practice Address - Street 1:124 N 10TH ST
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:OK
Practice Address - Zip Code:74021-2318
Practice Address - Country:US
Practice Address - Phone:918-850-4176
Practice Address - Fax:918-623-1600
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3828111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor