Provider Demographics
NPI:1821159351
Name:BLAIR, CHRISTOPHER RONALD (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:RONALD
Last Name:BLAIR
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 1:415 LAKE AIR DR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-5837
Mailing Address - Country:US
Mailing Address - Phone:254-751-1606
Mailing Address - Fax:254-772-6118
Practice Address - Street 1:415 LAKE AIR DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-5837
Practice Address - Country:US
Practice Address - Phone:254-751-1606
Practice Address - Fax:254-772-6118
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8124111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health