Healthcare Provider Details

I. General information

NPI: 1407762677
Provider Name (Legal Business Name): CHRISTOPHER DILLON CONNOLLY D.C. #35117
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 WESTERN AVE
PETELUMA CA
94952
US

IV. Provider business mailing address

710 ENGLISH ST
PETELUMA CA
94952
US

V. Phone/Fax

Practice location:
  • Phone: 707-291-4643
  • Fax: 707-596-7833
Mailing address:
  • Phone: 707-291-2546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number35117
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: