Provider Demographics
NPI:1508055476
Name:KNUTSON, CHRISTOPHER BRANDOND (DC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:BRANDOND
Last Name:KNUTSON
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 1:16633 DALLAS PKWY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-6816
Mailing Address - Country:US
Mailing Address - Phone:972-380-0000
Mailing Address - Fax:972-380-0042
Practice Address - Street 1:16633 DALLAS PKWY
Practice Address - Street 2:SUITE 150
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-6816
Practice Address - Country:US
Practice Address - Phone:972-417-9999
Practice Address - Fax:972-380-0042
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8456111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU93076OtherCOMMERICAL UPIN
TX8G9910OtherBLUE CROSS BLUE SHIELD
TX8G9910OtherBLUE CROSS BLUE SHIELD