MEDICARE: CHRISTOPHER B. POWELL 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	DC009459	PA

General Provider Information

NPI Number	:	1265434989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER B. POWELL D.C.

Provider Business Mailing Address
First Line	:	1141 S BRADDOCK AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15218-1250
Country	:	US
Telephone Number	:	412-243-9355
Fax Number	:	412-243-8040

Provider Business Practice Location Address
First Line	:	1141 S BRADDOCK AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15218-1250
Country	:	US
Telephone Number	:	412-243-9355
Fax Number	:	412-243-8040

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

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	11/02/2015

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