Provider Demographics
NPI:1659699155
Name:MASSIMINI, CHRISTOPHER M (DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:M
Last Name:MASSIMINI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 MULLET RUN
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19963-5373
Mailing Address - Country:US
Mailing Address - Phone:302-424-1810
Mailing Address - Fax:302-424-3092
Practice Address - Street 1:329 MULLET RUN
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-5373
Practice Address - Country:US
Practice Address - Phone:302-424-1810
Practice Address - Fax:302-424-3092
Is Sole Proprietor?:No
Enumeration Date:2010-05-07
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0002605225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist