Provider Demographics
NPI:1285814087
Name:WHITE, CHRISTOPHER SEAN (CMT)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:SEAN
Last Name:WHITE
Suffix:
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4964 WARD RD
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-2124
Mailing Address - Country:US
Mailing Address - Phone:303-463-5576
Mailing Address - Fax:303-421-0315
Practice Address - Street 1:4964 WARD RD
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-2124
Practice Address - Country:US
Practice Address - Phone:303-463-5576
Practice Address - Fax:303-421-0315
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9030171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor