Provider Demographics
NPI:1467766568
Name:CHRIS E. CEMBALISTY D.C., P.C.
Entity Type:Organization
Organization Name:CHRIS E. CEMBALISTY D.C., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:CEMBALISTY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-256-7604
Mailing Address - Street 1:1036 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-7560
Mailing Address - Country:US
Mailing Address - Phone:970-256-7604
Mailing Address - Fax:970-256-0244
Practice Address - Street 1:1036 N 4TH ST
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-7560
Practice Address - Country:US
Practice Address - Phone:970-256-7604
Practice Address - Fax:970-256-0244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-30
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4309111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC47673Medicare PIN