Provider Demographics
NPI:1568504421
Name:MAREAN, CHRISTOPHER CHARLES (PT)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:CHARLES
Last Name:MAREAN
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 1:10 MAPLE DR APT 4
Mailing Address - Street 2:
Mailing Address - City:ORRINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04474-3874
Mailing Address - Country:US
Mailing Address - Phone:386-871-6933
Mailing Address - Fax:866-220-5031
Practice Address - Street 1:10 MAPLE DR APT 4
Practice Address - Street 2:
Practice Address - City:ORRINGTON
Practice Address - State:ME
Practice Address - Zip Code:04474-3874
Practice Address - Country:US
Practice Address - Phone:386-871-6933
Practice Address - Fax:866-220-5031
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 22779225100000X
MEPT4091225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist