Provider Demographics
NPI:1871871830
Name:MCDONOUGH, CHRISTOPHER P (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:P
Last Name:MCDONOUGH
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 1:9315 COLUMBIA RD SW
Mailing Address - Street 2:
Mailing Address - City:ETNA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-7126
Mailing Address - Country:US
Mailing Address - Phone:740-963-3900
Mailing Address - Fax:740-963-3999
Practice Address - Street 1:9315 COLUMBIA RD SW
Practice Address - Street 2:
Practice Address - City:ETNA
Practice Address - State:OH
Practice Address - Zip Code:43062-7126
Practice Address - Country:US
Practice Address - Phone:740-963-3900
Practice Address - Fax:740-963-3999
Is Sole Proprietor?:No
Enumeration Date:2011-07-25
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4005111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor