Provider Demographics
NPI:1871767160
Name:FLAHERTY, CHRISTA MICHELLE (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTA
Middle Name:MICHELLE
Last Name:FLAHERTY
Suffix:
Gender:F
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:PO BOX 5170
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34611-5170
Mailing Address - Country:US
Mailing Address - Phone:352-684-5225
Mailing Address - Fax:352-684-5227
Practice Address - Street 1:10525 HEARTH RD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-3714
Practice Address - Country:US
Practice Address - Phone:352-684-5225
Practice Address - Fax:352-684-5227
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8583111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL89382OtherBC PROVIDER NUMBER
FL89382OtherBC PROVIDER NUMBER
FLU99034Medicare UPIN