Provider Demographics
NPI:1841296787
Name:CHRISTIE, ERIC N (DC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:N
Last Name:CHRISTIE
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 1:3359 W 38TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-4203
Mailing Address - Country:US
Mailing Address - Phone:814-838-3830
Mailing Address - Fax:814-838-3831
Practice Address - Street 1:3359 W 38TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-4203
Practice Address - Country:US
Practice Address - Phone:814-838-3830
Practice Address - Fax:814-838-3831
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2016-06-10
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
PADC007099L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001312784OtherHIGHMARK BC/BS
PA005875Medicare ID - Type Unspecified
PA001312784OtherHIGHMARK BC/BS