Provider Demographics
NPI:1770524076
Name:BLACK, CHRISTOPHER S (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:S
Last Name:BLACK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:140 POINT JUDITH RD
Mailing Address - Street 2:#30
Mailing Address - City:NARRAGANSETT
Mailing Address - State:RI
Mailing Address - Zip Code:02882-3451
Mailing Address - Country:US
Mailing Address - Phone:401-782-4884
Mailing Address - Fax:401-782-0272
Practice Address - Street 1:140 POINT JUDITH RD
Practice Address - Street 2:#30
Practice Address - City:NARRAGANSETT
Practice Address - State:RI
Practice Address - Zip Code:02882-3451
Practice Address - Country:US
Practice Address - Phone:401-782-4884
Practice Address - Fax:401-782-0272
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RI00372111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIU68078Medicare UPIN