Provider Demographics
NPI:1457358830
Name:TREACY, CHRISTINE S (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:S
Last Name:TREACY
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 1:1976 E HIGH ST
Mailing Address - Street 2:STE 204
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-3277
Mailing Address - Country:US
Mailing Address - Phone:610-327-8090
Mailing Address - Fax:610-327-0970
Practice Address - Street 1:1976 E HIGH ST
Practice Address - Street 2:STE 204
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-3277
Practice Address - Country:US
Practice Address - Phone:610-327-8090
Practice Address - Fax:610-327-0970
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-007902-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU82410Medicare UPIN
PA043394PLUMedicare ID - Type Unspecified
PA044684Medicare ID - Type UnspecifiedGROUP ID #