Provider Demographics
NPI:1851466767
Name:CEMBALISTY, CHRIS EDWARD (DC, PC)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:EDWARD
Last Name:CEMBALISTY
Suffix:
Gender:M
Credentials:DC, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1036 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-7560
Mailing Address - Country:US
Mailing Address - Phone:970-256-7604
Mailing Address - Fax:970-256-0244
Practice Address - Street 1:1036 N 4TH ST
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-7560
Practice Address - Country:US
Practice Address - Phone:970-256-7604
Practice Address - Fax:970-256-0244
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4309111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO4309OtherSTATE PROVIDER NUMBER
CO84-1566087OtherTIN
CO4309OtherSTATE PROVIDER NUMBER