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Individual

DR. CHRIS KOULTUKIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC., LAC

Contact information

Practice address
315 W 57TH ST, SUITE 308, NEW YORK, NY 10019-3158
(212) 580-2900
(212) 265-0217
Mailing address
315 W 57TH ST, SUITE 308, NEW YORK, NY 10019-3158
(212) 580-2900
(212) 265-0217

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X004361-1
NY
171100000X
Acupuncturist
001046
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001046
ACUPUNCTURE LICIENCE
NY
01
X004361-1
CHIROPRACTIC LICENCE
NY
Enumeration date
02/09/2007
Last updated
10/22/2007
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