Provider Demographics
NPI:1275572158
Name:GRAY, CHRISTOPHER J (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:J
Last Name:GRAY
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 1:122 S GOOSE CREEK BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-3136
Mailing Address - Country:US
Mailing Address - Phone:843-553-2211
Mailing Address - Fax:843-553-2210
Practice Address - Street 1:122 S GOOSE CREEK BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-3136
Practice Address - Country:US
Practice Address - Phone:843-553-2211
Practice Address - Fax:843-553-2210
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2771111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH2771Medicaid
SCCH2771Medicaid
SCU96519Medicare UPIN