Provider Demographics
NPI:1245591734
Name:ACKERMAN, CHRISTOPHER MARC (DPT, PCS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MARC
Last Name:ACKERMAN
Suffix:
Gender:M
Credentials:DPT, PCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:3355 MISSION AVE
Mailing Address - Street 2:123
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92058-1326
Mailing Address - Country:US
Mailing Address - Phone:760-529-4975
Mailing Address - Fax:760-529-4761
Practice Address - Street 1:3355 MISSION AVE
Practice Address - Street 2:123
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92058-1326
Practice Address - Country:US
Practice Address - Phone:760-529-4975
Practice Address - Fax:760-529-4761
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 275052251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics