Provider Demographics
NPI:1558784421
Name:CHRISTOPHER DAVID
Entity Type:Organization
Organization Name:CHRISTOPHER DAVID
Other - Org Name:ALLIANCE CHIROPRACTIC
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGING ENITITY
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:LANE
Authorized Official - Last Name:DAVID
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:502-367-2112
Mailing Address - Street 1:10701 W MANSLICK RD
Mailing Address - Street 2:
Mailing Address - City:FAIRDALE
Mailing Address - State:KY
Mailing Address - Zip Code:40118-9581
Mailing Address - Country:US
Mailing Address - Phone:502-367-2112
Mailing Address - Fax:502-367-7799
Practice Address - Street 1:10701 W MANSLICK RD
Practice Address - Street 2:
Practice Address - City:FAIRDALE
Practice Address - State:KY
Practice Address - Zip Code:40118-9581
Practice Address - Country:US
Practice Address - Phone:502-367-2112
Practice Address - Fax:502-367-7799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-29
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4932111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty