Basic Information
| Provider Information | |||||||||
| NPI: | 1003002098 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DEVENS | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 35104 EUCLID AVE | ||||||||
| Address2: | |||||||||
| City: | WILLOUGHBY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440944516 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4408675102 | ||||||||
| FaxNumber: | 8666598883 | ||||||||
| Practice Location | |||||||||
| Address1: | 35104 EUCLID AVE | ||||||||
| Address2: | |||||||||
| City: | WILLOUGHBY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440944516 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4408675102 | ||||||||
| FaxNumber: | 8666598883 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/24/2007 | ||||||||
| LastUpdateDate: | 11/04/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 10654 | TX | N | Chiropractic Providers | Chiropractor | 111NN1001X | 3808 | OH | Y | Chiropractic Providers | Chiropractor | Nutrition |
No ID Information.