Provider Demographics
NPI:1326651498
Name:JUNEAU, CHRISTOPHER M (PT, DPT, SCS, CSCS)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:M
Last Name:JUNEAU
Suffix:
Gender:M
Credentials:PT, DPT, SCS, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 FARNHAM PT APT 208
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-5202
Mailing Address - Country:US
Mailing Address - Phone:318-715-8415
Mailing Address - Fax:
Practice Address - Street 1:US AIR FORCE/ FORT CARSON
Practice Address - Street 2:8420 SKYRAIDER RD
Practice Address - City:COLORADO SPRINGS
Practice Address - State:AA
Practice Address - Zip Code:80913
Practice Address - Country:US
Practice Address - Phone:318-715-8415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.00171792251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports