Provider Demographics
NPI:1811000276
Name:CHRISTENSEN, KIM COSTON (DO)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:COSTON
Last Name:CHRISTENSEN
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Gender:M
Credentials:DO
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Mailing Address - Street 1:2150 WEST 700 NORTH
Mailing Address - Street 2:KIM C. CHRISTENSEN D.O. FAA SL/ARTCC MFO
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84116
Mailing Address - Country:US
Mailing Address - Phone:801-320-2440
Mailing Address - Fax:801-320-2449
Practice Address - Street 1:2150 WEST 700 NORTH
Practice Address - Street 2:KIM C. CHRISTENSEN D.O. FAA SL/ARTCC MFO
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84116
Practice Address - Country:US
Practice Address - Phone:801-320-2440
Practice Address - Fax:801-320-2449
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
UT07257150252083A0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine