Provider Demographics
NPI:1639186836
Name:PUTNAM, CHRISTOPHER SCOTT (PT)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:SCOTT
Last Name:PUTNAM
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:19705 IVEY RD
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-9478
Mailing Address - Country:US
Mailing Address - Phone:734-475-9925
Mailing Address - Fax:734-475-9927
Practice Address - Street 1:350 N MAIN ST
Practice Address - Street 2:SUITE: 180
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-1370
Practice Address - Country:US
Practice Address - Phone:734-475-9925
Practice Address - Fax:734-475-9927
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501010815225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist