Healthcare Provider Details

I. General information

NPI: 1720505449
Provider Name (Legal Business Name): CHRISTOPHER A SHELDEN LMT, C ROLFER TM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2017
Last Update Date: 09/27/2023
Certification Date: 09/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 W NORTHERN LIGHTS BLVD
ANCHORAGE AK
99503-2502
US

IV. Provider business mailing address

2419 LA HONDA DR
ANCHORAGE AK
99517-1343
US

V. Phone/Fax

Practice location:
  • Phone: 907-274-9345
  • Fax: 907-274-9345
Mailing address:
  • Phone: 907-229-4439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number151375
License Number StateAK
# 3
Primary TaxonomyN
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: