Provider Demographics
NPI:1568615102
Name:CHRISTENSEN ACCIDENT & INJURY CENTER, P.A.
Entity Type:Organization
Organization Name:CHRISTENSEN ACCIDENT & INJURY CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:E
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-778-0716
Mailing Address - Street 1:1073 PAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55130-3883
Mailing Address - Country:US
Mailing Address - Phone:651-778-0716
Mailing Address - Fax:651-778-0726
Practice Address - Street 1:1073 PAYNE AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55130-3883
Practice Address - Country:US
Practice Address - Phone:651-778-0716
Practice Address - Fax:651-778-0726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3460111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty