Individual
MR. CHRISTOPHER ROBERT FAGERNESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
498 4TH AVE NE, SIOUX CENTER, IA 51250-1606
(712) 722-6312
Mailing address
2800 PIERCE ST, SIOUX CITY, IA 51104-3755
(605) 421-9835
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
00438
IA
Other
Enumeration date
01/02/2009
Last updated
01/02/2009
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