Provider Demographics
NPI:1124136114
Name:BRANCO, CHRISTOPHER ANTHONY (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ANTHONY
Last Name:BRANCO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5919 OLEANDER DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-4780
Mailing Address - Country:US
Mailing Address - Phone:910-799-9700
Mailing Address - Fax:910-799-9780
Practice Address - Street 1:5919 OLEANDER DR
Practice Address - Street 2:SUITE 103
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-4780
Practice Address - Country:US
Practice Address - Phone:910-799-9700
Practice Address - Fax:910-799-9780
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2518111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC790830MMedicaid
NC0830MOtherBCBS
NC0830MOtherBCBS
2453165AMedicare ID - Type Unspecified