Provider Demographics
NPI:1669465902
Name:KRSKO, CHRISTINE M (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:M
Last Name:KRSKO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7683 OVERLOOK DR
Mailing Address - Street 2:
Mailing Address - City:GREENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53129-2139
Mailing Address - Country:US
Mailing Address - Phone:414-421-7003
Mailing Address - Fax:
Practice Address - Street 1:7000 S 76TH ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-9077
Practice Address - Country:US
Practice Address - Phone:414-525-9500
Practice Address - Fax:414-525-0900
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2010-07-26
Deactivation Date:2006-03-27
Deactivation Code:
Reactivation Date:2006-04-04
Provider Licenses
StateLicense IDTaxonomies
WI1365-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000070120Medicare ID - Type Unspecified