Provider Demographics
NPI:1407863004
Name:LEVEL, CHRISTOPHER WAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:WAYNE
Last Name:LEVEL
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:NMRTU
Mailing Address - Street 2:1 WAHOO DRIVE
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06349
Mailing Address - Country:US
Mailing Address - Phone:314-221-3626
Mailing Address - Fax:
Practice Address - Street 1:NMRTU
Practice Address - Street 2:1 WAHOO DRIVE
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06349
Practice Address - Country:US
Practice Address - Phone:314-221-3626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002010528111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000025525Medicare ID - Type Unspecified
MOU92058Medicare UPIN