Provider Demographics
NPI:1134409386
Name:MANSOLF, CHRISTOPHER SCOTT (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:SCOTT
Last Name:MANSOLF
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:3742 TENNESSEE AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37409-1222
Mailing Address - Country:US
Mailing Address - Phone:423-602-5656
Mailing Address - Fax:423-602-5678
Practice Address - Street 1:3742 TENNESSEE AVE STE 104
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37409-1222
Practice Address - Country:US
Practice Address - Phone:423-602-5656
Practice Address - Fax:423-602-5678
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-19
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5297111N00000X
COCHR 0007040111N00000X
GACHIR009783111N00000X
TN0000002900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor