Provider Demographics
NPI:1366507311
Name:FAHS, CHRISTOPHER (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:FAHS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 W SOUTH BOULDER RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-1156
Mailing Address - Country:US
Mailing Address - Phone:303-666-4151
Mailing Address - Fax:303-666-4166
Practice Address - Street 1:315 W SOUTH BOULDER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-1156
Practice Address - Country:US
Practice Address - Phone:303-666-4151
Practice Address - Fax:303-666-4166
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11116225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO11116OtherCO LICENSE NUMBER
COCOAAA1427Medicare PIN