Basic Information
Provider Information
NPI: 1003002098
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DEVENS
FirstName: CHRISTOPHER
MiddleName: J
NamePrefix: DR.
NameSuffix:  
Credential: D.C.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2676 E AURORA RD
Address2:  
City: TWINSBURG
State: OH
PostalCode: 440872150
CountryCode: US
TelephoneNumber: 3304252477
FaxNumber:  
Practice Location
Address1: 2676 E. AURORA RD
Address2: SUITE 16
City: CONCORD TWP
State: OH
PostalCode: 440779609
CountryCode: US
TelephoneNumber: 3304252477
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/24/2007
LastUpdateDate: 10/06/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
111N00000X10654TXN Chiropractic ProvidersChiropractor 
111NN1001X3808OHY Chiropractic ProvidersChiropractorNutrition

No ID Information.


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