Provider Demographics
NPI:1639893282
Name:OUTTEN CHIROPRACTIC PA
Entity Type:Organization
Organization Name:OUTTEN CHIROPRACTIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:R
Authorized Official - Last Name:OUTTEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-467-3362
Mailing Address - Street 1:401 HIGH HOUSE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-7201
Mailing Address - Country:US
Mailing Address - Phone:919-467-3362
Mailing Address - Fax:919-467-3233
Practice Address - Street 1:401 HIGH HOUSE RD STE 110
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-7201
Practice Address - Country:US
Practice Address - Phone:919-467-3362
Practice Address - Fax:919-467-3233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8908642Medicaid