Doctor Name: | SHANNON DIANE CHRISTIANSON |
NPI Number: | 1003001975 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPT |
License Number: | |
Business Practice Address: | 3900 E Pacific Coast Hwy Long Beach, CA - 908042013 |
Business Phone Number: | 5629862375 |
Business Fax Number: | |
Mailing Address: | 3900 E Pacific Coast Hwy, LONG BEACH |
State: | CA |
Postal Code: | 908042013 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 09/12/2007 |
NPI Last Update Date: | 11/28/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |