Provider Demographics
NPI:1225153844
Name:CHRISTENSEN, WAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:
Last Name:CHRISTENSEN
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 1:20231 E OCOTILLO RD
Mailing Address - Street 2:STE1
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-7639
Mailing Address - Country:US
Mailing Address - Phone:480-677-3900
Mailing Address - Fax:480-677-8310
Practice Address - Street 1:20231 E OCOTILLO RD
Practice Address - Street 2:STE1
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-7639
Practice Address - Country:US
Practice Address - Phone:480-677-3900
Practice Address - Fax:480-677-8310
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5944111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor