Provider Demographics
NPI:1154816015
Name:OKSANEN, CHRISTOPHER ANDREW
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ANDREW
Last Name:OKSANEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 WHITE TAIL LN
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-5351
Mailing Address - Country:US
Mailing Address - Phone:203-901-8544
Mailing Address - Fax:
Practice Address - Street 1:60 WHITE TAIL LN
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-5351
Practice Address - Country:US
Practice Address - Phone:203-901-8544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-24
Last Update Date:2018-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPT006172225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist