Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 10654 | TX |
Y | 111NN1001X | Nutrition | 3808 | OH |
NPI | 1003002098 |
---|---|
Provider Name | Dr. Christopher J Devens |
First Address | Willoughby, OH 44094-4516 |
Second Address | Willoughby, OH 44094-4516 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2007 |
Last Update Date | 04/11/2019 |