Provider Demographics
NPI:1851502306
Name:BURNHAM, CHRISTOPHER RYAN (DC, BS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:RYAN
Last Name:BURNHAM
Suffix:
Gender:M
Credentials:DC, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 N FEDERAL HWY STE 1
Mailing Address - Street 2:
Mailing Address - City:LAKE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33403-3531
Mailing Address - Country:US
Mailing Address - Phone:561-932-8275
Mailing Address - Fax:561-516-8072
Practice Address - Street 1:330 N FEDERAL HWY STE 1
Practice Address - Street 2:
Practice Address - City:LAKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33403-3531
Practice Address - Country:US
Practice Address - Phone:561-932-8275
Practice Address - Fax:561-516-8072
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556528111N00000X
FLCH10080111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor