Provider Demographics
NPI:1205838869
Name:DOCKTER, CHRISTOPHER ALLEN (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ALLEN
Last Name:DOCKTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:620 CIVIC HEIGHTS DR
Mailing Address - Street 2:STE 108
Mailing Address - City:CIRCLE PINES
Mailing Address - State:MN
Mailing Address - Zip Code:55014-4711
Mailing Address - Country:US
Mailing Address - Phone:763-795-8300
Mailing Address - Fax:763-795-8302
Practice Address - Street 1:805 2ND ST SE
Practice Address - Street 2:
Practice Address - City:PINE CITY
Practice Address - State:MN
Practice Address - Zip Code:55063-2101
Practice Address - Country:US
Practice Address - Phone:320-629-6717
Practice Address - Fax:320-629-6718
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN003433111N00000X
MN00403171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN610060OOtherFIRST HEALTH
MN1990925OtherFIRST HEALTH
MN306317800Medicaid
MN306317800Medicaid
MN1990925OtherFIRST HEALTH