Provider Demographics
NPI:1568401727
Name:CHRISTENSEN, JOSHUA (DC)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:CHRISTENSEN
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 1:25 N 325 E
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025-3415
Mailing Address - Country:US
Mailing Address - Phone:801-671-3552
Mailing Address - Fax:
Practice Address - Street 1:630 SHEPARD LN
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:UT
Practice Address - Zip Code:84025-3934
Practice Address - Country:US
Practice Address - Phone:801-447-8680
Practice Address - Fax:801-447-4211
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5329340-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT53293401203001OtherBCBS UTAH