Provider Demographics
NPI:1629851837
Name:HATTON, CHRISTOPHER CONNOR
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:CONNOR
Last Name:HATTON
Suffix:
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 1:9087 ATHOL RD
Mailing Address - Street 2:
Mailing Address - City:MARDELA SPRINGS
Mailing Address - State:MD
Mailing Address - Zip Code:21837-2410
Mailing Address - Country:US
Mailing Address - Phone:410-430-4829
Mailing Address - Fax:
Practice Address - Street 1:900 BOOTH ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-3006
Practice Address - Country:US
Practice Address - Phone:410-742-8896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA5865225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant