Provider Demographics
NPI:1457325763
Name:HUOT, CHRISTOPHER JASON (ATC, CSCS)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JASON
Last Name:HUOT
Suffix:
Gender:M
Credentials:ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3014 34TH ST S
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-6937
Mailing Address - Country:US
Mailing Address - Phone:218-477-5972
Mailing Address - Fax:
Practice Address - Street 1:1104 7TH AVE S
Practice Address - Street 2:106 C NEMZEK HALL
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56563-0001
Practice Address - Country:US
Practice Address - Phone:218-477-5972
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN18292255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer