Provider Demographics
NPI:1912923160
Name:FETTER, CHRISTOPHER TODD (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:TODD
Last Name:FETTER
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 1:2335 US HIGHWAY 43
Mailing Address - Street 2:PO BOX 1319
Mailing Address - City:WINFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35594
Mailing Address - Country:US
Mailing Address - Phone:205-487-8865
Mailing Address - Fax:205-487-2371
Practice Address - Street 1:2335 US HIGHWAY 43
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:AL
Practice Address - Zip Code:35594
Practice Address - Country:US
Practice Address - Phone:205-487-8865
Practice Address - Fax:205-487-2371
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1812111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALU70378Medicare UPIN