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General NPI Number Information
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NPI Number | 1174637672
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Entity Type | Organization
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Legal Business Name | CHRISTENSEN CHIROPRACTIC PC
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 630 W SHEPHARD LANE
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City | FARMINGTON
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State | UT
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Zip | 84025-3934
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Country | US
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Telephone | 801-447-8680
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Fax | 801-447-4211
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Provider Business Mailing Address
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Address Line | 630 W. SHEPHARD LANE #102
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City | FARMINGTON
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State | UT
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Zip | 84025-3934
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Country | US
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Telephone | 801-447-8680
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Fax | 801-447-4211
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | MR. JOSHUA CHRISTENSEN
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Credential | DC
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Telephone | 801-447-8680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5329340-1202
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License Number State | UT
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