Provider Demographics
NPI:1376660639
Name:VENABLE, CHRISTOPHER BRETT (DC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:BRETT
Last Name:VENABLE
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 1:207 RUE LOUIS XIV
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-5737
Mailing Address - Country:US
Mailing Address - Phone:337-988-2188
Mailing Address - Fax:337-988-2187
Practice Address - Street 1:207 RUE LOUIS XIV
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-5737
Practice Address - Country:US
Practice Address - Phone:337-988-2188
Practice Address - Fax:337-988-2187
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1435111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAV12481Medicare UPIN