Provider Demographics
NPI:1548485287
Name:BAUER, CHRISTOPHER ALAN (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ALAN
Last Name:BAUER
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 1:1618 POLAR DR
Mailing Address - Street 2:
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-3357
Mailing Address - Country:US
Mailing Address - Phone:636-639-8056
Mailing Address - Fax:
Practice Address - Street 1:22 PETER ST
Practice Address - Street 2:
Practice Address - City:NEW MELLE
Practice Address - State:MO
Practice Address - Zip Code:63365
Practice Address - Country:US
Practice Address - Phone:636-828-5151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO111N00000X111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO31180Medicare UPIN