Provider Demographics
NPI:1356505432
Name:COVERT, CHRISTOPHER ALLEN (DPT, CSCS, OCS)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ALLEN
Last Name:COVERT
Suffix:
Gender:M
Credentials:DPT, CSCS, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 36TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-1005
Mailing Address - Country:US
Mailing Address - Phone:304-917-3660
Mailing Address - Fax:304-917-3674
Practice Address - Street 1:1212 GARFIELD AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-3247
Practice Address - Country:US
Practice Address - Phone:304-865-6778
Practice Address - Fax:304-865-7400
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV002696225100000X
OHPT 012939225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810013118Medicaid
P00712142OtherRAILROAD MEDICARE
OH2873010Medicaid
WV4243212Medicare PIN
P00712142OtherRAILROAD MEDICARE