Provider Demographics
NPI:1740672310
Name:SOOLE, CHRISTINE MICHELLE (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:MICHELLE
Last Name:SOOLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:MICHELLE
Other - Last Name:STETTNICHS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 913
Mailing Address - Street 2:
Mailing Address - City:OKOBOJI
Mailing Address - State:IA
Mailing Address - Zip Code:51355-0913
Mailing Address - Country:US
Mailing Address - Phone:712-332-8604
Mailing Address - Fax:712-332-8604
Practice Address - Street 1:1017 HIGHWAY 71 S
Practice Address - Street 2:
Practice Address - City:OKOBOJI
Practice Address - State:IA
Practice Address - Zip Code:51355
Practice Address - Country:US
Practice Address - Phone:712-332-8604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-19
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01575111N00000X
COCHR.0007568111N00000X
IA095170111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor