Provider Demographics
NPI:1326404898
Name:TODD W CHRISTENSEN OD PLLC
Entity Type:Organization
Organization Name:TODD W CHRISTENSEN OD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:515-223-7215
Mailing Address - Street 1:1551 VALLEY WEST DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1112
Mailing Address - Country:US
Mailing Address - Phone:515-223-7215
Mailing Address - Fax:515-223-6333
Practice Address - Street 1:1551 VALLEY WEST DR
Practice Address - Street 2:SUITE 100
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1112
Practice Address - Country:US
Practice Address - Phone:515-223-7215
Practice Address - Fax:515-223-6333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-13
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01887152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty