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General NPI Number Information
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NPI Number | 1235793423
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Entity Type | Individual
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Provider Name | CHRISTIAN AAGE NELDEBERG
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Gender | Male
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Dates
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Enumeration Date | 04/24/2019
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 224 S MAIN ST
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City | RIVER FALLS
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State | WI
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Zip | 54022-2424
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Country | US
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Telephone | 712-420-2917
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Fax |
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Provider Business Mailing Address
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Address Line | 941 FAIRCHILD DR
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City | RIVER FALLS
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State | WI
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Zip | 54022-4274
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Country | US
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Telephone | 712-420-2917
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 5428-12
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License Number State | WI
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