Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | ||
Y | 222Z00000X | Podiatrist | ||
N | 224P00000X | Prosthetist |
NPI | 1306183116 |
---|---|
Provider Name | Erik D Christensen |
First Address | Roanoke, VA 24012-2821 |
Second Address | Eden, NC 27288-5013 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2013 |
Last Update Date | 14/05/2014 |