Provider Demographics
NPI:1689713711
Name:GREGORY, CHRISTIAN CLAXTON (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:CLAXTON
Last Name:GREGORY
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 1:4123 CONNECTICUT AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-1155
Mailing Address - Country:US
Mailing Address - Phone:202-265-6000
Mailing Address - Fax:202-265-6018
Practice Address - Street 1:4123 CONNECTICUT AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-1155
Practice Address - Country:US
Practice Address - Phone:202-265-6000
Practice Address - Fax:202-265-6018
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCCH30013111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCU991108Medicare UPIN
DCG01462M01Medicare ID - Type Unspecified