Provider Demographics
NPI:1356654727
Name:WILHELM, CHRISTOPHER ALVIN (PTA)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:ALVIN
Last Name:WILHELM
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 LEGION AVE
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47006-8947
Mailing Address - Country:US
Mailing Address - Phone:812-212-3029
Mailing Address - Fax:
Practice Address - Street 1:12803 LENOVER STREET
Practice Address - Street 2:THE WATERS OF DILLSBORO-ROSS
Practice Address - City:DILLSBORO
Practice Address - State:IN
Practice Address - Zip Code:47018
Practice Address - Country:US
Practice Address - Phone:812-432-3114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06002935A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant