Provider Demographics
NPI:1093829525
Name:WERTIN, CHRISTOPHER LUKE
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:LUKE
Last Name:WERTIN
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 1:3300 BOB BILLINGS
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049
Mailing Address - Country:US
Mailing Address - Phone:785-842-4181
Mailing Address - Fax:785-842-6436
Practice Address - Street 1:3300 BOB BILLINGS
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049
Practice Address - Country:US
Practice Address - Phone:785-842-4181
Practice Address - Fax:785-842-6436
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0103767111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
055010OtherBCBS
KS2237463OtherAETNA
KS055010Medicare ID - Type Unspecified