Provider Demographics
NPI:1780651091
Name:GORDOS, CHRISTOPHER SCOTT (DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:SCOTT
Last Name:GORDOS
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 1:805 N RICHMOND ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FLEETWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19522-1058
Mailing Address - Country:US
Mailing Address - Phone:610-944-8140
Mailing Address - Fax:610-944-8190
Practice Address - Street 1:805 N RICHMOND ST
Practice Address - Street 2:SUITE 103
Practice Address - City:FLEETWOOD
Practice Address - State:PA
Practice Address - Zip Code:19522-1058
Practice Address - Country:US
Practice Address - Phone:610-944-8140
Practice Address - Fax:610-944-8190
Is Sole Proprietor?:No
Enumeration Date:2006-03-06
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT011166L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist