Provider Demographics
NPI:1639145980
Name:ALFORD, CHRISTOPHER THOMAS (PT, SCS, ATC, CSCS)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:THOMAS
Last Name:ALFORD
Suffix:
Gender:M
Credentials:PT, SCS, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:658 AARON CIRCLE
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:GA
Mailing Address - Zip Code:31032
Mailing Address - Country:US
Mailing Address - Phone:478-986-5400
Mailing Address - Fax:478-986-5443
Practice Address - Street 1:571 HAMMOCK RD NW
Practice Address - Street 2:SUITE 106
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-7184
Practice Address - Country:US
Practice Address - Phone:478-452-6252
Practice Address - Fax:478-452-6255
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA6061225100000X
SC3025225100000X
GA7702255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
1639145980Medicare PIN
65BBCGMMedicare UPIN