Provider Demographics
NPI:1811997307
Name:CHRISTENSEN, MONICA SUE (DC)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:SUE
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 NYGAARD ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:STOUGHTON
Mailing Address - State:WI
Mailing Address - Zip Code:53589-5491
Mailing Address - Country:US
Mailing Address - Phone:608-873-9003
Mailing Address - Fax:608-873-9007
Practice Address - Street 1:1200 NYGAARD ST
Practice Address - Street 2:SUITE 202
Practice Address - City:STOUGHTON
Practice Address - State:WI
Practice Address - Zip Code:53589-5491
Practice Address - Country:US
Practice Address - Phone:608-873-9003
Practice Address - Fax:608-873-9007
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3694111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38932500Medicaid
WIU74409Medicare UPIN
WI000035392Medicare ID - Type Unspecified