Provider Demographics
NPI:1205894896
Name:GISEWHITE, CHRISTIE R (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTIE
Middle Name:R
Last Name:GISEWHITE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 ELECTRIC AVE
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17044-1126
Mailing Address - Country:US
Mailing Address - Phone:717-242-4476
Mailing Address - Fax:717-242-8558
Practice Address - Street 1:505 ELECTRIC AVE
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-1126
Practice Address - Country:US
Practice Address - Phone:717-242-4476
Practice Address - Fax:717-242-8558
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005082L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016139460001Medicaid
PAU34906Medicare UPIN
PA0016139460001Medicaid