Provider Demographics
NPI:1306183116
Name:CHRISTENSEN, ERIK D (CPO)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:D
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4338 WILLIAMSON RD NW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24012-2821
Mailing Address - Country:US
Mailing Address - Phone:540-366-8287
Mailing Address - Fax:540-366-3050
Practice Address - Street 1:439 W KINGS HWY
Practice Address - Street 2:
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-5013
Practice Address - Country:US
Practice Address - Phone:336-623-6500
Practice Address - Fax:336-623-6501
Is Sole Proprietor?:No
Enumeration Date:2013-01-14
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist