Provider Demographics
NPI:1588000988
Name:BANTOCK, CHRISTOPHER (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:BANTOCK
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 1:4500 CHERRY CREEK DRIVE SOUTH SUITE 103
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CO
Mailing Address - Zip Code:80246
Mailing Address - Country:US
Mailing Address - Phone:303-518-8117
Mailing Address - Fax:
Practice Address - Street 1:4500 CHERRY CREEK DRIVE SOUTH SUITE #103
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CO
Practice Address - Zip Code:80246
Practice Address - Country:US
Practice Address - Phone:303-518-8117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-13
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0006985111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor