Provider Demographics
NPI:1811244288
Name:BARTHOLOMEW, CHRISTINE KAY (DC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:KAY
Last Name:BARTHOLOMEW
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:KAY
Other - Last Name:BARTHOLOMEW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18345 DEER RUN CT
Mailing Address - Street 2:
Mailing Address - City:PRIOR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55372-9727
Mailing Address - Country:US
Mailing Address - Phone:651-829-4752
Mailing Address - Fax:
Practice Address - Street 1:9202 202ND ST W STE 203
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55044-7918
Practice Address - Country:US
Practice Address - Phone:952-469-8385
Practice Address - Fax:952-469-1713
Is Sole Proprietor?:No
Enumeration Date:2012-08-05
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5602111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor