Provider Demographics
NPI:1437272341
Name:CHRISTIANSON PFAU CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:CHRISTIANSON PFAU CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:CHRISTIANSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:608-643-7803
Mailing Address - Street 1:1190 PRAIRIE STREET
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE DU SAC
Mailing Address - State:WI
Mailing Address - Zip Code:53578
Mailing Address - Country:US
Mailing Address - Phone:608-643-7803
Mailing Address - Fax:608-643-7832
Practice Address - Street 1:1190 PRAIRIE STREET
Practice Address - Street 2:
Practice Address - City:PRAIRIE DU SAC
Practice Address - State:WI
Practice Address - Zip Code:53578
Practice Address - Country:US
Practice Address - Phone:608-643-7803
Practice Address - Fax:608-643-7832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty