Provider Demographics
NPI:1710217872
Name:POWELL, CHRISTOPHER M (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:M
Last Name:POWELL
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 1:254 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-3625
Mailing Address - Country:US
Mailing Address - Phone:770-754-4567
Mailing Address - Fax:
Practice Address - Street 1:72 THOMPSON ST
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-3724
Practice Address - Country:US
Practice Address - Phone:770-754-4567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-12
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor