Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 170100000X | Medical Geneticist | PA0471 | TN |
NPI | 1699867861 |
---|---|
Provider Name | Christopher Manoli Chrisohon |
First Address | Elizabethton, TN 37643-2848 |
Second Address | Elizabethton, TN 37643-2848 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 16/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1514495 | (05) | TN |
PO2889 | (02) | TN |