Provider Demographics
NPI:1093876740
Name:CHRISTENSEN CHIROPRACTIC PC
Entity Type:Organization
Organization Name:CHRISTENSEN CHIROPRACTIC PC
Other - Org Name:ALTOONA FAMILY CHIROPRACTIC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:TATE
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-967-7169
Mailing Address - Street 1:507 8TH ST SE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:IA
Mailing Address - Zip Code:50009-1903
Mailing Address - Country:US
Mailing Address - Phone:515-967-7169
Mailing Address - Fax:515-967-8470
Practice Address - Street 1:507 8TH ST SE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:IA
Practice Address - Zip Code:50009-1903
Practice Address - Country:US
Practice Address - Phone:515-967-7169
Practice Address - Fax:515-967-8470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty