Provider Demographics
NPI:1912129602
Name:KRAEMER, CHRISTOPHER CHARLES (PT, MPT)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:CHARLES
Last Name:KRAEMER
Suffix:
Gender:M
Credentials:PT, MPT
Other - Prefix:
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Mailing Address - Street 1:2176 E FRANKLIN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-9024
Mailing Address - Country:US
Mailing Address - Phone:208-288-1155
Mailing Address - Fax:208-288-0424
Practice Address - Street 1:3170 43RD ST S
Practice Address - Street 2:SUITE 101
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-8808
Practice Address - Country:US
Practice Address - Phone:701-277-8448
Practice Address - Fax:701-277-8668
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ND1119225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist