Provider Demographics
NPI:1265434989
Name:POWELL, CHRISTOPHER B (DC)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:B
Last Name:POWELL
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 1:1141 S BRADDOCK AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15218-1250
Mailing Address - Country:US
Mailing Address - Phone:412-243-9355
Mailing Address - Fax:412-243-8040
Practice Address - Street 1:1141 S BRADDOCK AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15218-1250
Practice Address - Country:US
Practice Address - Phone:412-243-9355
Practice Address - Fax:412-243-8040
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009459111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor