Provider Demographics
NPI:1306867908
Name:MCKENNEY, CHRIS W (DC)
Entity type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:W
Last Name:MCKENNEY
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 1:5608 SE 113TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:BELLEVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:34420-4038
Mailing Address - Country:US
Mailing Address - Phone:352-245-8955
Mailing Address - Fax:352-245-9156
Practice Address - Street 1:5608 SE 113TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:BELLEVIEW
Practice Address - State:FL
Practice Address - Zip Code:34420-4038
Practice Address - Country:US
Practice Address - Phone:352-245-8955
Practice Address - Fax:352-245-9156
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH4336111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00291511OtherMEDICARE RAILROAD
FL70367OtherBCBS OF FLORIDA
FL70367OtherBCBS OF FLORIDA
FLP00291511OtherMEDICARE RAILROAD