Healthcare Provider Details

I. General information

NPI: 1437480621
Provider Name (Legal Business Name): PAUL MARTIN CHRISTENSEN P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2010
Last Update Date: 01/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2855 INTERNATIONAL CIR
COLORADO SPRINGS CO
80910-3144
US

IV. Provider business mailing address

3055 W WHILEAWAY CIR
COLORADO SPRINGS CO
80917-3523
US

V. Phone/Fax

Practice location:
  • Phone: 719-447-8822
  • Fax:
Mailing address:
  • Phone: 719-380-0230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1626
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: