Provider Demographics
NPI:1154474443
Name:HOUTAKKER, CHRISTOPHER R (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:R
Last Name:HOUTAKKER
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 1:11155 S EASTERN AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4387
Mailing Address - Country:US
Mailing Address - Phone:702-456-5900
Mailing Address - Fax:702-898-0093
Practice Address - Street 1:11155 S EASTERN AVE STE 120
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4387
Practice Address - Country:US
Practice Address - Phone:702-456-5900
Practice Address - Fax:702-898-0093
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB-927111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor