Provider Demographics
NPI:1225111248
Name:BRILL, CHRISTOPHER MATTHEW (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MATTHEW
Last Name:BRILL
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 1:716 A THIMBLE SHOALS BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-2574
Mailing Address - Country:US
Mailing Address - Phone:757-873-4131
Mailing Address - Fax:757-240-5795
Practice Address - Street 1:716 A THIMBLE SHOALS BLVD
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-2574
Practice Address - Country:US
Practice Address - Phone:757-873-4131
Practice Address - Fax:757-240-5795
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001907111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA000300519Medicaid
VA393226OtherBLUE CROSS BLUE SHIELD