MEDICARE: DR. CHRISTOPHER ANDREW GADDIE II D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	038011096	IL
2	111N00000X	Chiropractor	2008001512	MO

General Provider Information

NPI Number	:	1194995191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER ANDREW GADDIE II D.C.

Provider Business Mailing Address
First Line	:	6841 GRAVOIS AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63116-1162
Country	:	US
Telephone Number	:	314-353-4357
Fax Number	:	314-353-2028

Provider Business Practice Location Address
First Line	:	6841 GRAVOIS AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63116-1162
Country	:	US
Telephone Number	:	314-353-4357
Fax Number	:	314-353-2028

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2008
Last Update Date	:	10/02/2023

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