Doctor Name: | CLINT AUSTIN CHRISTENSEN |
NPI Number: | 1013276039 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 960 E 3rd St Ste 104 Chattanooga, TN - 374032138 |
Business Phone Number: | 4237787628 |
Business Fax Number: | |
Mailing Address: | 282 Rock Spring Rd, OWENS CROSS ROADS |
State: | AL |
Postal Code: | 357639578 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/11/2012 |
NPI Last Update Date: | 05/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |