Provider Demographics
NPI:1588764625
Name:LOPER, CHRISTOPHER TODD (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:TODD
Last Name:LOPER
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:PO BOX 242
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27828-0242
Mailing Address - Country:US
Mailing Address - Phone:252-753-8020
Mailing Address - Fax:252-753-8020
Practice Address - Street 1:3826 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:NC
Practice Address - Zip Code:27828-8548
Practice Address - Country:US
Practice Address - Phone:252-753-8020
Practice Address - Fax:252-753-8020
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2884111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89085NKMedicaid
NC89085NKMedicaid
NCU96278Medicare UPIN