Provider Information for 1073925020
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CHRIS MCKILLOP LPCA, NCC
Sex: Male
NPI: 1073925020
Last Updated: 2014-05-27
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1073925020 | ||||||||
| Enumeration Date | 2014-05-27 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 410 JOHN ST MONROE, NC 28110-3251 United States Phone: 704-238-8195 | Fax: | ||||||||
| Primary Practice Address | 410 JOHN ST MONROE, NC 28110-3251 United States Phone: 704-238-8195 | Fax: | ||||||||
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