MEDICARE: CHRISTINA JUDON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	4713	NC

General Provider Information

NPI Number	:	1639683956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA JUDON

Provider Business Mailing Address
First Line	:	PO BOX 686
Second Line	:
City	:	CHANHASSEN
State	:	MN
Zip	:	55317-0686
Country	:	US
Telephone Number	:	952-229-7558
Fax Number	:

Provider Business Practice Location Address
First Line	:	5020 CAROTHERS PKWY
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-6009
Country	:	US
Telephone Number	:	615-685-7057
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2017
Last Update Date	:	02/22/2018

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Directions to “ CHRISTINA JUDON ” Practice Location

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