Provider Demographics
NPI:1578581120
Name:RECKSIEDLER, CHRISTOPHER C (DC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:C
Last Name:RECKSIEDLER
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 1:40 ALEXANDRIA BLVD STE 1020
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-8910
Mailing Address - Country:US
Mailing Address - Phone:407-359-0047
Mailing Address - Fax:407-359-0071
Practice Address - Street 1:40 ALEXANDRIA BLVD STE 1020
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-8910
Practice Address - Country:US
Practice Address - Phone:407-359-0047
Practice Address - Fax:407-359-0071
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6418111N00000X
SC1552111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLV11118Medicare UPIN
FLAA342ZMedicare PIN