Provider Demographics
NPI:1487716866
Name:DEVEAU, CHRISTOPHER DAVID (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:DAVID
Last Name:DEVEAU
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 1:1353 GOLD STAR HWY
Mailing Address - Street 2:SUITE 106
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-2739
Mailing Address - Country:US
Mailing Address - Phone:860-446-9700
Mailing Address - Fax:860-326-5728
Practice Address - Street 1:1353 GOLD STAR HWY
Practice Address - Street 2:SUITE 106
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-2739
Practice Address - Country:US
Practice Address - Phone:860-446-9700
Practice Address - Fax:860-326-5728
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001172111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTU62938Medicare UPIN
CT350001346Medicare ID - Type Unspecified