Basic Information
Provider Information
NPI: 1760590103
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KUHN
FirstName: CHRISTOPHER
MiddleName: JOHN
NamePrefix:  
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3111 124TH AVE NW
Address2:  
City: COON RAPIDS
State: MN
PostalCode: 554334572
CountryCode: US
TelephoneNumber: 7634277300
FaxNumber: 7634272802
Practice Location
Address1: 3111 124TH AVE NW
Address2:  
City: COON RAPIDS
State: MN
PostalCode: 554334572
CountryCode: US
TelephoneNumber: 7634277300
FaxNumber: 7634272802
Other Information
ProviderEnumerationDate: 08/27/2006
LastUpdateDate: 01/07/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/07/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X7595MNY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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