Provider Demographics
NPI:1336490788
Name:LIMES, CHRISTOPHER COLLIN (RT(T)(R))
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:COLLIN
Last Name:LIMES
Suffix:
Gender:M
Credentials:RT(T)(R)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 HOLLYWOOD ST
Mailing Address - Street 2:
Mailing Address - City:COFFEYVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:67337-2228
Mailing Address - Country:US
Mailing Address - Phone:620-204-0517
Mailing Address - Fax:
Practice Address - Street 1:1400 W 4TH ST
Practice Address - Street 2:
Practice Address - City:COFFEYVILLE
Practice Address - State:KS
Practice Address - Zip Code:67337-3306
Practice Address - Country:US
Practice Address - Phone:620-204-0517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-25
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS22-03979247100000X, 2471R0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471R0002XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiation Therapy
No247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist