Provider Demographics
NPI:1700920865
Name:VIESSELMAN, CHRISTOPHER PAUL (LAT, ATC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:PAUL
Last Name:VIESSELMAN
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 GRANDVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50316-1529
Mailing Address - Country:US
Mailing Address - Phone:515-263-2871
Mailing Address - Fax:515-263-2871
Practice Address - Street 1:1200 GRANDVIEW AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50316-1529
Practice Address - Country:US
Practice Address - Phone:515-263-2871
Practice Address - Fax:515-263-2871
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002892255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer