Provider Demographics
NPI:1902166267
Name:CHRISTOPHER W GEORGE CHIROPRACTIC INC
Entity Type:Organization
Organization Name:CHRISTOPHER W GEORGE CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:323-656-4194
Mailing Address - Street 1:1042 N FAIRFAX AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90046-6103
Mailing Address - Country:US
Mailing Address - Phone:323-656-4194
Mailing Address - Fax:323-656-4151
Practice Address - Street 1:1042 N FAIRFAX AVE
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90046-6103
Practice Address - Country:US
Practice Address - Phone:323-656-4194
Practice Address - Fax:323-656-4151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-31149111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty