Provider Demographics
NPI:1790881142
Name:GEHRISCH, CHRISTOPHER LEE (DC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:LEE
Last Name:GEHRISCH
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 1:33 S LEXINGTON
Mailing Address - Street 2:SPRINGMILL RD
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906
Mailing Address - Country:US
Mailing Address - Phone:419-529-5544
Mailing Address - Fax:419-529-8525
Practice Address - Street 1:33 S LEXINGTON
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906
Practice Address - Country:US
Practice Address - Phone:419-529-5544
Practice Address - Fax:419-529-8525
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3091111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2229083Medicaid
000000251175OtherANTHEM
U84490Medicare UPIN
000000251175OtherANTHEM