Provider Demographics
NPI:1871592899
Name:BEYER, CHRISTINE A (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:A
Last Name:BEYER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:438 N 57TH AVE W
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55807-3723
Mailing Address - Country:US
Mailing Address - Phone:218-624-5759
Mailing Address - Fax:218-624-4668
Practice Address - Street 1:438 N 57TH AVE W
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55807-3723
Practice Address - Country:US
Practice Address - Phone:218-624-5759
Practice Address - Fax:218-624-4668
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2105111N00000X
WI2084-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN638827200Medicaid
MN60635AUOtherBCBS
MN359000099Medicare PIN
T65260Medicare UPIN
MN350021417Medicare PIN