Provider Demographics
NPI:1184027534
Name:TEIGEN, CHRISTINE
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:TEIGEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:DIANE
Other - Last Name:WELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:534 MAIN ST N UNIT B
Mailing Address - Street 2:
Mailing Address - City:HORACE
Mailing Address - State:ND
Mailing Address - Zip Code:58047-4640
Mailing Address - Country:US
Mailing Address - Phone:701-361-4984
Mailing Address - Fax:
Practice Address - Street 1:534 MAIN ST N UNIT B
Practice Address - Street 2:
Practice Address - City:HORACE
Practice Address - State:ND
Practice Address - Zip Code:58047-4640
Practice Address - Country:US
Practice Address - Phone:701-361-4984
Practice Address - Fax:701-353-2077
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1012225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist