Healthcare Provider Details

I. General information

NPI: 1003319419
Provider Name (Legal Business Name): CHRISTOPHER PAUL GEHRKE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2018
Last Update Date: 03/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16419 NORTHCROSS DR STE C
HUNTERSVILLE NC
28078-5008
US

IV. Provider business mailing address

120 MONUMENT CT
MOORESVILLE NC
28115-3464
US

V. Phone/Fax

Practice location:
  • Phone: 707-895-7227
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4881
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: