Provider Demographics
NPI:1619754652
Name:BARTH, CHRISTOPHER JONATHAN (NC LMBT 18645)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JONATHAN
Last Name:BARTH
Suffix:
Gender:M
Credentials:NC LMBT 18645
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5125 COPPER RIDGE DR APT 104
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-5594
Mailing Address - Country:US
Mailing Address - Phone:919-590-5502
Mailing Address - Fax:
Practice Address - Street 1:6406 MCCRIMMON PKWY STE 210
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-8145
Practice Address - Country:US
Practice Address - Phone:919-941-0026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18645225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist