Provider Demographics
NPI:1497453294
Name:SUTER, CHRISTOPHER GRAHAM (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:GRAHAM
Last Name:SUTER
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 1:2430 8TH ST APT 3
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94710-2531
Mailing Address - Country:US
Mailing Address - Phone:916-833-7026
Mailing Address - Fax:
Practice Address - Street 1:1840 SAN MIGUEL DR STE 100
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-8603
Practice Address - Country:US
Practice Address - Phone:925-378-7652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA303706225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist