Provider Demographics
NPI:1093002297
Name:CANCIENNE, CHRISTOPHER JOHN (DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:CANCIENNE
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 1:504 RUE DE SANTE
Mailing Address - Street 2:
Mailing Address - City:LAPLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068
Mailing Address - Country:US
Mailing Address - Phone:985-652-9515
Mailing Address - Fax:
Practice Address - Street 1:504 RUE DE SANTE
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-5418
Practice Address - Country:US
Practice Address - Phone:985-652-9515
Practice Address - Fax:985-652-8675
Is Sole Proprietor?:No
Enumeration Date:2011-07-08
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA08038225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist