Provider Demographics
NPI:1235214297
Name:HERBSTER, CHRISTOPHER J (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:J
Last Name:HERBSTER
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 1:430 INNOVATION DRIVE
Mailing Address - Street 2:
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15717-8096
Mailing Address - Country:US
Mailing Address - Phone:724-343-4060
Mailing Address - Fax:724-343-4069
Practice Address - Street 1:120 MAIN ST
Practice Address - Street 2:
Practice Address - City:WATSONTOWN
Practice Address - State:PA
Practice Address - Zip Code:17777-1723
Practice Address - Country:US
Practice Address - Phone:570-538-1488
Practice Address - Fax:570-539-1599
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT006951L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1858164OtherHIGHMARK BLUE SHIELD
PA1373407OtherAETNA
PA274208OtherHEALTH AMER/HEALTH ASSUR.
PA50060684OtherCAPITAL/KHPC
PA820327OtherBCNE/FIRST PRIORITY H.
PA50060684OtherCAPITAL/KHPC