Provider Demographics
NPI:1467450189
Name:HANCOCK, CHRISTI MICHELLE (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTI
Middle Name:MICHELLE
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:CHRISTI
Other - Middle Name:MICHELLE
Other - Last Name:RALPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:4203 E US HIGHWAY 54
Mailing Address - Street 2:
Mailing Address - City:LINN CREEK
Mailing Address - State:MO
Mailing Address - Zip Code:65052-1745
Mailing Address - Country:US
Mailing Address - Phone:573-346-3777
Mailing Address - Fax:573-346-3891
Practice Address - Street 1:4203 E US HIGHWAY 54
Practice Address - Street 2:
Practice Address - City:LINN CREEK
Practice Address - State:MO
Practice Address - Zip Code:65052-1745
Practice Address - Country:US
Practice Address - Phone:573-346-3777
Practice Address - Fax:573-346-3891
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005001318111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1194998450OtherGROUP NPI
MO2005001318OtherLICENSE #
MO000015705Medicare UPIN
MOV04749Medicare UPIN
MO258005705Medicare UPIN