Provider Demographics
NPI:1639263312
Name:MOBLEY, CHRISTOPHER (MPT, CSCS)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:
Last Name:MOBLEY
Suffix:
Gender:M
Credentials:MPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5772 DOWLING RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185
Mailing Address - Country:US
Mailing Address - Phone:734-525-1968
Mailing Address - Fax:734-525-3896
Practice Address - Street 1:30260 CHERRY HILL ROAD
Practice Address - Street 2:SUITE B
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135
Practice Address - Country:US
Practice Address - Phone:734-525-1968
Practice Address - Fax:734-525-3896
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501010744225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501010744OtherSTATE LICENCE