Provider Demographics
NPI:1083615074
Name:OLIVER, CHRISTOPHER T (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:T
Last Name:OLIVER
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 1:1041 STERLING RD STE 106
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-3841
Mailing Address - Country:US
Mailing Address - Phone:703-904-8528
Mailing Address - Fax:703-904-8529
Practice Address - Street 1:1041 STERLING RD STE 106
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-3841
Practice Address - Country:US
Practice Address - Phone:703-904-8528
Practice Address - Fax:703-904-8529
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001903111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAU66799Medicare UPIN
VA490239Medicare PIN