Provider Demographics
NPI:1477709715
Name:CAZENAVE, CHRISTOPHER CHARLES (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:CHARLES
Last Name:CAZENAVE
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HEADLAND
Mailing Address - State:AL
Mailing Address - Zip Code:36345-2051
Mailing Address - Country:US
Mailing Address - Phone:334-790-3242
Mailing Address - Fax:
Practice Address - Street 1:950 S SAINT ANDREWS ST
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-3684
Practice Address - Country:US
Practice Address - Phone:334-793-7711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1357314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility