Provider Demographics
NPI:1023179520
Name:PERRY, CHRISTOPHER MICHAEL (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:MICHAEL
Last Name:PERRY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4650 HILLS AND DALES RD NW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-1510
Mailing Address - Country:US
Mailing Address - Phone:330-477-9720
Mailing Address - Fax:330-458-4610
Practice Address - Street 1:4650 HILLS AND DALES RD NW
Practice Address - Street 2:SUITE 100
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-1510
Practice Address - Country:US
Practice Address - Phone:330-477-9720
Practice Address - Fax:330-458-4610
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT 010432225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPT - 010432OtherPT LICENSE