Provider Demographics
NPI:1164753844
Name:CHUTKOWSKI, CHRISTOPHER (OTR/L)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:CHUTKOWSKI
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1981 MEMORIAL DRIVE
Mailing Address - Street 2:PMB 217
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-4322
Mailing Address - Country:US
Mailing Address - Phone:888-511-4723
Mailing Address - Fax:
Practice Address - Street 1:1981 MEMORIAL DR
Practice Address - Street 2:PMB 217
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-4322
Practice Address - Country:US
Practice Address - Phone:888-511-4723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8415225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist