Provider Demographics
NPI:1609124247
Name:NELSEN, CHRISTINE L (RMT)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:L
Last Name:NELSEN
Suffix:
Gender:F
Credentials:RMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 28 1/4 RD UNIT 1
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-4961
Mailing Address - Country:US
Mailing Address - Phone:970-242-8162
Mailing Address - Fax:
Practice Address - Street 1:514 28 1/4 RD UNIT 1
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-4961
Practice Address - Country:US
Practice Address - Phone:970-242-8162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11520174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist