Provider Demographics
NPI:1598002313
Name:VANN, CHRISTOPHER MATTHEW (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MATTHEW
Last Name:VANN
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 1:5833 S GOLDENROD RD STE F
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-8777
Mailing Address - Country:US
Mailing Address - Phone:407-704-6705
Mailing Address - Fax:407-704-6254
Practice Address - Street 1:5833 S GOLDENROD RD STE F
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-8777
Practice Address - Country:US
Practice Address - Phone:407-704-6705
Practice Address - Fax:407-704-6254
Is Sole Proprietor?:No
Enumeration Date:2013-01-14
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10812111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor