Provider Demographics
NPI:1073662920
Name:ORECCHIO, CHRISTOPHER (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:ORECCHIO
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 1:17620 W DARBY RD
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-9309
Mailing Address - Country:US
Mailing Address - Phone:937-747-2393
Mailing Address - Fax:
Practice Address - Street 1:1504 W 1ST AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-3427
Practice Address - Country:US
Practice Address - Phone:614-485-2347
Practice Address - Fax:614-485-2561
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5609225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHOR0793944Medicare ID - Type UnspecifiedPRIVATE PRACTICE PT