Provider Demographics
NPI:1033624200
Name:EAST, CHRIS FRANK
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:FRANK
Last Name:EAST
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 CEDAR RIDGE FARM RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27358-9314
Mailing Address - Country:US
Mailing Address - Phone:336-327-1996
Mailing Address - Fax:
Practice Address - Street 1:1506 CEDAR RIDGE FARM RD
Practice Address - Street 2:
Practice Address - City:SUMMERFIELD
Practice Address - State:NC
Practice Address - Zip Code:27358-9314
Practice Address - Country:US
Practice Address - Phone:336-327-1996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-09
Last Update Date:2017-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC049101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty