Provider Demographics
NPI:1376247510
Name:RHODES, CHRISTOPHER RAY
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:RAY
Last Name:RHODES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1538 RIPLEY RD
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:WV
Mailing Address - Zip Code:25276-8750
Mailing Address - Country:US
Mailing Address - Phone:304-377-8975
Mailing Address - Fax:
Practice Address - Street 1:1538 RIPLEY RD
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:WV
Practice Address - Zip Code:25276-8750
Practice Address - Country:US
Practice Address - Phone:304-377-8975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant