Provider Demographics
NPI:1871715938
Name:CHRISTIE, DAVID WILLIAM (DC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:WILLIAM
Last Name:CHRISTIE
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 1:689 CALABASAS RD
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-0413
Mailing Address - Country:US
Mailing Address - Phone:831-728-4263
Mailing Address - Fax:
Practice Address - Street 1:284 PENNSYLVANIA DR
Practice Address - Street 2:SUITE #1
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-3768
Practice Address - Country:US
Practice Address - Phone:831-728-1030
Practice Address - Fax:831-728-8811
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC21871111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor