Provider Demographics
NPI:1972674075
Name:KAISER, CHRISTINE MARIE (LAC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MARIE
Last Name:KAISER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25001 EMERY RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WARRENSVILLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44128-5626
Mailing Address - Country:US
Mailing Address - Phone:216-285-4070
Mailing Address - Fax:
Practice Address - Street 1:25001 EMERY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44128-5626
Practice Address - Country:US
Practice Address - Phone:216-285-4070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-11
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH66.000024171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist