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General NPI Number Information
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NPI Number | 1598197857
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Entity Type | Organization
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Legal Business Name | CHRISTENSEN FOOT & ANKLE CLINIC
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Dates
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Enumeration Date | 08/08/2013
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Last Update Date | 08/08/2013
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Provider Practice Location Address
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Address Line | 1777 E CLARK ST SUITE 220
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City | POCATELLO
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State | ID
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Zip | 83201-3357
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Country | US
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Telephone | 208-235-1777
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Fax | 208-232-7518
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Provider Business Mailing Address
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Address Line | 1777 E CLARK ST SUITE 220
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City | POCATELLO
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State | ID
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Zip | 83201-3357
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Country | US
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Telephone | 208-235-1777
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Fax | 208-232-7518
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. HUI MIN CHRISTENSEN
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Credential |
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Telephone | 208-235-1777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | P-166
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 213ER0200X
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Taxonomy Name | Radiology Podiatrist
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License Number | P-166
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 213ES0000X
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Taxonomy Name | Sports Medicine Podiatrist
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License Number | P-166
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License Number State | ID
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Taxonomy #4
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | P-166
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License Number State | ID
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Taxonomy #5
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | P-166
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License Number State | ID
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Taxonomy #6
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | P-166
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License Number State | ID
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