Provider Demographics
NPI:1235338294
Name:PECSOK, CHRISTOPHER L (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:L
Last Name:PECSOK
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 1:1531 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-2117
Mailing Address - Country:US
Mailing Address - Phone:513-236-9017
Mailing Address - Fax:
Practice Address - Street 1:4158 CROSSGATE LN
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45236-1216
Practice Address - Country:US
Practice Address - Phone:513-236-9017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2555111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0855721Medicare PIN