Provider Demographics
NPI:1740610591
Name:MARION, CHRISTOPHER DONALD (MSPT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:DONALD
Last Name:MARION
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 NW LINSTER PL
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-1335
Mailing Address - Country:US
Mailing Address - Phone:406-546-9043
Mailing Address - Fax:
Practice Address - Street 1:246 NW LINSTER PL
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-1335
Practice Address - Country:US
Practice Address - Phone:406-546-9043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-14
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR04926225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist