Provider Demographics
NPI:1740652817
Name:PROULX, CHRISTOPHER (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:PROULX
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 1:88 GARNEY RD
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03872-7407
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:88 GARNEY RD
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:NH
Practice Address - Zip Code:03872-7407
Practice Address - Country:US
Practice Address - Phone:603-540-0617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH633-0501111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor