Provider Demographics
NPI:1598353245
Name:HILL, CHRISTIAN JACOB
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:JACOB
Last Name:HILL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19007 W 168TH ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-3711
Mailing Address - Country:US
Mailing Address - Phone:870-754-3991
Mailing Address - Fax:
Practice Address - Street 1:19007 W 168TH ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-3711
Practice Address - Country:US
Practice Address - Phone:870-754-3991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications