Provider Demographics
NPI:1033697537
Name:HUPF, CHRISTOPHER T (DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:T
Last Name:HUPF
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 E ENTERPRISE AVE STE 113
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913-7862
Mailing Address - Country:US
Mailing Address - Phone:920-560-1083
Mailing Address - Fax:920-560-1098
Practice Address - Street 1:145 N COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-3005
Practice Address - Country:US
Practice Address - Phone:920-215-6225
Practice Address - Fax:920-215-3947
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-06
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1407857790OtherGROUP NPI
WI39-1930290OtherGROUP TAX ID