Healthcare Provider Details

I. General information

NPI: 1710203047
Provider Name (Legal Business Name): BRYT CHRISTENSEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2010
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2891 E MALL DR STE 101
ST GEORGE UT
84790-2399
US

IV. Provider business mailing address

PO BOX 912042
ST GEORGE UT
84791-2042
US

V. Phone/Fax

Practice location:
  • Phone: 435-656-2424
  • Fax: 435-656-2828
Mailing address:
  • Phone: 435-215-0230
  • Fax: 435-986-7092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number23014
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number9189225-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: