Provider Demographics
NPI:1578858312
Name:BEARDEN, CHRISTOPHER MICHAEL (DC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:MICHAEL
Last Name:BEARDEN
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 1:1807 TAFT HWY
Mailing Address - Street 2:SUITE 6
Mailing Address - City:SIGNAL MOUNTAIN
Mailing Address - State:TN
Mailing Address - Zip Code:37377-3528
Mailing Address - Country:US
Mailing Address - Phone:423-886-3330
Mailing Address - Fax:423-886-4440
Practice Address - Street 1:1807 TAFT HWY
Practice Address - Street 2:SUITE 6
Practice Address - City:SIGNAL MOUNTAIN
Practice Address - State:TN
Practice Address - Zip Code:37377-3528
Practice Address - Country:US
Practice Address - Phone:423-886-3330
Practice Address - Fax:423-886-4440
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2510111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor