Provider Demographics
NPI:1275781239
Name:DETERMAN, CHRISTOPHER DONALD (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:DONALD
Last Name:DETERMAN
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 1:100 E HIGHWAY 14
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:MN
Mailing Address - Zip Code:56178-1101
Mailing Address - Country:US
Mailing Address - Phone:507-247-3249
Mailing Address - Fax:
Practice Address - Street 1:251 N TYLER ST
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:MN
Practice Address - Zip Code:56178-1161
Practice Address - Country:US
Practice Address - Phone:507-247-3249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5134111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor