Provider Demographics
NPI:1336237536
Name:CHRISTOPHERSON, DAISY ELIZABETH (DPT)
Entity type:Individual
Prefix:
First Name:DAISY
Middle Name:ELIZABETH
Last Name:CHRISTOPHERSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:739 BIRCH LN
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55057-2902
Mailing Address - Country:US
Mailing Address - Phone:507-581-9249
Mailing Address - Fax:
Practice Address - Street 1:1381 JEFFERSON RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55057-3080
Practice Address - Country:US
Practice Address - Phone:507-646-8800
Practice Address - Fax:507-646-8801
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7491225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist