Provider Demographics
NPI:1003044710
Name:CHRISTY, COLBY MCVAY (MAC)
Entity Type:Individual
Prefix:MR
First Name:COLBY
Middle Name:MCVAY
Last Name:CHRISTY
Suffix:
Gender:M
Credentials:MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 ASHLEY AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401-1249
Mailing Address - Country:US
Mailing Address - Phone:843-442-4566
Mailing Address - Fax:
Practice Address - Street 1:114 ASHLEY AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-1249
Practice Address - Country:US
Practice Address - Phone:843-442-4566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-01
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC101171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist