Provider Demographics
NPI:1255327839
Name:MAGGIORE, CHRISTOPHER DAX (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:DAX
Last Name:MAGGIORE
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 1:915 E OCEAN BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2426
Mailing Address - Country:US
Mailing Address - Phone:772-286-3650
Mailing Address - Fax:772-286-2649
Practice Address - Street 1:915 E OCEAN BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2426
Practice Address - Country:US
Practice Address - Phone:772-286-3650
Practice Address - Fax:772-286-2649
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 7526111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55934AMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER