Provider Demographics
NPI:1306866306
Name:MEYER, CHRISTOPHER JUDE (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JUDE
Last Name:MEYER
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 1:2733 MANITOWOC RD
Mailing Address - Street 2:STE 10
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-4901
Mailing Address - Country:US
Mailing Address - Phone:920-465-1111
Mailing Address - Fax:920-465-1072
Practice Address - Street 1:2733 MANITOWOC RD STE 10
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-4901
Practice Address - Country:US
Practice Address - Phone:920-465-1111
Practice Address - Fax:920-465-1072
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3519-12111N00000X
WI3519-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000070145Medicare ID - Type UnspecifiedMEDICARE PROVIDER #