Provider Demographics
NPI:1235216813
Name:MONDEN, CHRIS M (DC, BS)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:M
Last Name:MONDEN
Suffix:
Gender:M
Credentials:DC, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 S AIR DEPOT BLVD
Mailing Address - Street 2:SUITE 31
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-4870
Mailing Address - Country:US
Mailing Address - Phone:405-736-6850
Mailing Address - Fax:405-736-6823
Practice Address - Street 1:1212 S AIR DEPOT BLVD
Practice Address - Street 2:SUITE 31
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-4870
Practice Address - Country:US
Practice Address - Phone:405-736-6850
Practice Address - Fax:405-736-6823
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3698111N00000X
TX9369111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor