MEDICARE: PETER ZANGS CHRISTENSON

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1891337416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER ZANGS CHRISTENSON

Provider Business Mailing Address
First Line	:	1872 HIGHWAY 13 N
Second Line	:
City	:	WATERVILLE
State	:	MN
Zip	:	56096-8710
Country	:	US
Telephone Number	:	651-329-9765
Fax Number	:

Provider Business Practice Location Address
First Line	:	7200 WASHINGTON AVE STE 103
Second Line	:
City	:	MOUNT PLEASANT
State	:	WI
Zip	:	53406-6516
Country	:	US
Telephone Number	:	262-583-0790
Fax Number	:

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

Provider Enumeration Date	:	10/15/2019
Last Update Date	:	10/15/2019

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