Provider Demographics
NPI:1295886489
Name:KISKER, CHRISTOPHER S (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:S
Last Name:KISKER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:67 SAND PIT RD
Mailing Address - Street 2:SUITE 99
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-4032
Mailing Address - Country:US
Mailing Address - Phone:203-791-9111
Mailing Address - Fax:203-791-9743
Practice Address - Street 1:67 SAND PIT RD
Practice Address - Street 2:SUITE 99
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-4032
Practice Address - Country:US
Practice Address - Phone:203-791-9111
Practice Address - Fax:203-791-9743
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT001577111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTU99891Medicare UPIN