Provider Demographics
NPI:1306022397
Name:OURGANIAN, CHRISTOPHER JAMES (DC,CCSP, ATC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JAMES
Last Name:OURGANIAN
Suffix:
Gender:M
Credentials:DC,CCSP, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2960 IMMOKALEE RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1439
Mailing Address - Country:US
Mailing Address - Phone:386-624-1948
Mailing Address - Fax:239-513-0043
Practice Address - Street 1:2960 IMMOKALEE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1439
Practice Address - Country:US
Practice Address - Phone:239-513-9800
Practice Address - Fax:239-513-0043
Is Sole Proprietor?:No
Enumeration Date:2008-01-21
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6185111N00000X
CO0604026882255A2300X
FLCH 9799111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
No111N00000XChiropractic ProvidersChiropractor
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL8673713OtherCIGNA ID
FL9276183OtherAETNA PIN
FL8414076OtherAETNA HMO PIN
FL004447700Medicaid
FL220JVOtherBCBS
FLK0166OtherMEDICARE GROUP ID
FLFX850ZOtherMEDICARE