Provider Demographics
NPI:1699497438
Name:STEWART, CHRISTOPHER (DC)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:STEWART
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 1:5851 SCOTTSVILLE RD STE 202
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-7973
Mailing Address - Country:US
Mailing Address - Phone:770-756-3612
Mailing Address - Fax:
Practice Address - Street 1:5833 SCOTTSVILLE RD STE 202
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-7853
Practice Address - Country:US
Practice Address - Phone:770-756-3612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY278646111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor