Provider Demographics
NPI:1033429543
Name:PERRY, CHRISTOPHER BRIAN (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:BRIAN
Last Name:PERRY
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 1:3130 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19132-2421
Mailing Address - Country:US
Mailing Address - Phone:267-239-0103
Mailing Address - Fax:267-239-0104
Practice Address - Street 1:3130 N BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19132-2421
Practice Address - Country:US
Practice Address - Phone:267-239-0103
Practice Address - Fax:267-239-0104
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-18
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010488111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor