Provider Demographics
NPI:1518190651
Name:DOCKTER, CHRISTOPHER DOUGLAS (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:DOUGLAS
Last Name:DOCKTER
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 1:2553 KIRSTEN LN S
Mailing Address - Street 2:STE 207
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-4901
Mailing Address - Country:US
Mailing Address - Phone:701-730-3867
Mailing Address - Fax:701-356-2992
Practice Address - Street 1:2553 KIRSTEN LN S
Practice Address - Street 2:SUITE 207
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-4901
Practice Address - Country:US
Practice Address - Phone:701-730-3867
Practice Address - Fax:701-356-2992
Is Sole Proprietor?:No
Enumeration Date:2009-08-24
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND841111N00000X
MN5211111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor