Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH 5756 | FL |
N | 111NN0400X | Neurology | CH 5756 | FL |
NPI | 1649721275 |
---|---|
Provider Name | Paul Kevin Christian |
First Address | Tampa, FL 33606-4034 |
Second Address | Tampa, FL 33606-4034 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2016 |
Last Update Date | 19/10/2016 |