Provider Demographics
NPI:1679563837
Name:HERZIG, CHRISTOPHER P (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:P
Last Name:HERZIG
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 1:196 COTTAGE ST
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-3004
Mailing Address - Country:US
Mailing Address - Phone:401-722-7537
Mailing Address - Fax:401-727-1633
Practice Address - Street 1:196 COTTAGE ST
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-3004
Practice Address - Country:US
Practice Address - Phone:401-722-7537
Practice Address - Fax:401-727-1633
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-27
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00231111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIT53289Medicare UPIN