Provider Demographics
NPI:1407140619
Name:WEIBEL-MAANUM, CHRISTIE MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIE
Middle Name:MARIE
Last Name:WEIBEL-MAANUM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 2ND ST NE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55413-1130
Mailing Address - Country:US
Mailing Address - Phone:612-378-3220
Mailing Address - Fax:612-378-3225
Practice Address - Street 1:1222 2ND ST NE
Practice Address - Street 2:SUITE 202
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55413-1130
Practice Address - Country:US
Practice Address - Phone:612-378-3220
Practice Address - Fax:612-378-3225
Is Sole Proprietor?:No
Enumeration Date:2011-06-06
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5556111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor