Provider Demographics
NPI:1205532843
Name:HAZARD, CHRISTOPHER (DC)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:HAZARD
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 1:160 TAUNTON AVE
Mailing Address - Street 2:
Mailing Address - City:EAST PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02914-4531
Mailing Address - Country:US
Mailing Address - Phone:401-435-2002
Mailing Address - Fax:401-435-3553
Practice Address - Street 1:160 TAUNTON AVE
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-4531
Practice Address - Country:US
Practice Address - Phone:401-435-2002
Practice Address - Fax:401-435-3553
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00710111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty