Provider Demographics
NPI:1609005701
Name:FOKUMLAH, CHRIS (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:
Last Name:FOKUMLAH
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 1:7420 UNITY AVE N
Mailing Address - Street 2:SUITE 204
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-3143
Mailing Address - Country:US
Mailing Address - Phone:763-560-0712
Mailing Address - Fax:763-560-9182
Practice Address - Street 1:7420 UNITY AVE N
Practice Address - Street 2:SUITE 204
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-3143
Practice Address - Country:US
Practice Address - Phone:763-560-0712
Practice Address - Fax:763-560-9182
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4371111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor