Provider Demographics
NPI:1326737297
Name:SMITH, CHRISTIAN R (DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:R
Last Name:SMITH
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7 DOCK HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17842-8910
Mailing Address - Country:US
Mailing Address - Phone:570-837-2123
Mailing Address - Fax:570-837-2185
Practice Address - Street 1:33 MAIN ST APT 1
Practice Address - Street 2:
Practice Address - City:MC ALISTERVILLE
Practice Address - State:PA
Practice Address - Zip Code:17049-8499
Practice Address - Country:US
Practice Address - Phone:717-463-3004
Practice Address - Fax:717-463-3006
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT031226225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist