Provider Demographics
NPI:1073258539
Name:DECKER, CHRISTY LYNN (ND, DACM, DIPL AC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTY
Middle Name:LYNN
Last Name:DECKER
Suffix:
Gender:F
Credentials:ND, DACM, DIPL AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 S WINTER ST APT A2
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-4340
Mailing Address - Country:US
Mailing Address - Phone:906-285-0297
Mailing Address - Fax:
Practice Address - Street 1:101 W MAUMEE ST
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-2019
Practice Address - Country:US
Practice Address - Phone:517-759-4018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.001601171100000X
MI5402000168171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist