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Individual

JASON M CHRISTIANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
2310 N 400 E, STE C, NORTH LOGAN, UT 84341
(435) 752-5200
(435) 752-5228
Mailing address
PO BOX 6518, NORTH LOGAN, UT 84341
(435) 752-5200
(435) 752-5228

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
59325882401
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
59325882400001
BCBS
UT
01
84854
PEHP
UT
Enumeration date
08/30/2006
Last updated
07/08/2007
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