MEDICARE: DR. CHRISTIAN REED SPILLER DC

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	DC011659	PA

General Provider Information

NPI Number	:	1205507068
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTIAN REED SPILLER DC

Provider Business Mailing Address
First Line	:	904 GRASSMERE AVE
Second Line	:
City	:	OCEAN
State	:	NJ
Zip	:	07712-4226
Country	:	US
Telephone Number	:	603-828-6435
Fax Number	:

Provider Business Practice Location Address
First Line	:	826 CHRISTIAN ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19147-3947
Country	:	US
Telephone Number	:	215-922-2242
Fax Number	:

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

Provider Enumeration Date	:	09/22/2021
Last Update Date	:	09/22/2021

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