Provider Demographics
NPI:1013044791
Name:BONI, CHRISTOPHER ALLEN (DC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ALLEN
Last Name:BONI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:361 BOWERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-2734
Mailing Address - Country:US
Mailing Address - Phone:859-248-8215
Mailing Address - Fax:
Practice Address - Street 1:1267 US HIGHWAY 127 S
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-4352
Practice Address - Country:US
Practice Address - Phone:502-223-2424
Practice Address - Fax:502-226-4005
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4751111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85003176Medicaid
KY85900470Medicaid
KY85003176Medicaid
KY85900470Medicaid