Provider Demographics
NPI:1205277209
Name:HILL, CHRISTIAN BRADFORD (LAC, MAC)
Entity type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:BRADFORD
Last Name:HILL
Suffix:
Gender:M
Credentials:LAC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 SAINT IVES DR
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-9473
Mailing Address - Country:US
Mailing Address - Phone:304-541-6729
Mailing Address - Fax:
Practice Address - Street 1:404B MIDLAND TRL
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-1632
Practice Address - Country:US
Practice Address - Phone:304-541-6729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-08
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV96219171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist