Provider Demographics
NPI:1518122746
Name:LABELLE, CHRISTOPHER ALAN II
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ALAN
Last Name:LABELLE
Suffix:II
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 1:19881 TOWNSHIP ROAD 133
Mailing Address - Street 2:
Mailing Address - City:RUSHSYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43347-9606
Mailing Address - Country:US
Mailing Address - Phone:937-407-4831
Mailing Address - Fax:
Practice Address - Street 1:19881 TOWNSHIP ROAD 133
Practice Address - Street 2:
Practice Address - City:RUSHSYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43347-9606
Practice Address - Country:US
Practice Address - Phone:937-407-4831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA06454225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant