Provider Demographics
NPI:1205507068
Name:SPILLER, CHRISTIAN REED (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:REED
Last Name:SPILLER
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 1:904 GRASSMERE AVE
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-4226
Mailing Address - Country:US
Mailing Address - Phone:603-828-6435
Mailing Address - Fax:
Practice Address - Street 1:826 CHRISTIAN ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-3947
Practice Address - Country:US
Practice Address - Phone:215-922-2242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011659111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty