Provider Demographics
NPI:1851515308
Name:MOSS, CHRISTOPHER LAWRENCE (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:LAWRENCE
Last Name:MOSS
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 1:1129 BATTLEFIELD BLVD N
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-4735
Mailing Address - Country:US
Mailing Address - Phone:757-547-5510
Mailing Address - Fax:757-547-1833
Practice Address - Street 1:1129 BATTLEFIELD BLVD N
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4735
Practice Address - Country:US
Practice Address - Phone:757-547-5510
Practice Address - Fax:757-547-1833
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001164111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA350000653Medicare ID - Type Unspecified