Provider Demographics
NPI:1215011325
Name:WOLNER, CHRISTOPHER DEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:DEAN
Last Name:WOLNER
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 1:2607 E HIGHWAY 7
Mailing Address - Street 2:
Mailing Address - City:MONTEVIDEO
Mailing Address - State:MN
Mailing Address - Zip Code:56265-1739
Mailing Address - Country:US
Mailing Address - Phone:320-269-4774
Mailing Address - Fax:
Practice Address - Street 1:2607 E HIGHWAY 7
Practice Address - Street 2:
Practice Address - City:MONTEVIDEO
Practice Address - State:MN
Practice Address - Zip Code:56265-1739
Practice Address - Country:US
Practice Address - Phone:320-269-4774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3414111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN117324300Medicaid
MN466L4ADOtherBLUE CROSS BLUE SHIELD
MN117324300Medicaid