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General NPI Number Information
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NPI Number | 1154474443
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Entity Type | Individual
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Provider Name | CHRISTOPHER R HOUTAKKER DC
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Gender | Male
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 04/10/2008
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Provider Practice Location Address
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Address Line | 11155 S EASTERN AVE STE 120
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City | HENDERSON
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State | NV
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Zip | 89052-4387
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Country | US
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Telephone | 702-456-5900
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Fax | 702-898-0093
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Provider Business Mailing Address
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Address Line | 11155 S EASTERN AVE STE 120
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City | HENDERSON
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State | NV
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Zip | 89052-4387
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Country | US
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Telephone | 702-456-5900
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Fax | 702-898-0093
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | B-927
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License Number State | NV
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