Provider Demographics
NPI:1417293432
Name:GOMES, CHRISTOPHER PAUL (DPT, OCS, CSCS)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:PAUL
Last Name:GOMES
Suffix:
Gender:M
Credentials:DPT, OCS, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 KELLEY BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-4185
Mailing Address - Country:US
Mailing Address - Phone:781-859-4189
Mailing Address - Fax:781-757-3564
Practice Address - Street 1:560 KELLEY BLVD STE 2
Practice Address - Street 2:
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760-4185
Practice Address - Country:US
Practice Address - Phone:781-859-4189
Practice Address - Fax:781-757-3564
Is Sole Proprietor?:No
Enumeration Date:2012-12-19
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT02550225100000X
MA20328225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist