Provider Demographics
NPI:1538203468
Name:DEPOLIS, CHRISTOPHER JOSEPH JR (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JOSEPH
Last Name:DEPOLIS
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1201 NEW RD
Mailing Address - Street 2:SUITE 117-B
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1150
Mailing Address - Country:US
Mailing Address - Phone:609-653-0700
Mailing Address - Fax:609-653-0017
Practice Address - Street 1:1201 NEW RD
Practice Address - Street 2:SUITE 117-B
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1150
Practice Address - Country:US
Practice Address - Phone:609-653-0700
Practice Address - Fax:609-653-0017
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00336300111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA156894Medicare UPIN