Provider Demographics
NPI:1982908141
Name:FIERRO, CHRISTOPHER (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:FIERRO
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 1:2207 W 1800 N
Mailing Address - Street 2:SUITE B
Mailing Address - City:CLINTON
Mailing Address - State:UT
Mailing Address - Zip Code:84015-7925
Mailing Address - Country:US
Mailing Address - Phone:801-896-0976
Mailing Address - Fax:801-896-0254
Practice Address - Street 1:2207 W 1800 N
Practice Address - Street 2:SUITE B
Practice Address - City:CLINTON
Practice Address - State:UT
Practice Address - Zip Code:84015-7925
Practice Address - Country:US
Practice Address - Phone:801-896-0976
Practice Address - Fax:801-896-0254
Is Sole Proprietor?:No
Enumeration Date:2011-01-03
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038011822111N00000X
UT8233971-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor