Provider Demographics
NPI:1801223367
Name:CONDRAN, CHRIS WOLFGANG (PT, DPT, MBA-HCM, MS)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:WOLFGANG
Last Name:CONDRAN
Suffix:
Gender:M
Credentials:PT, DPT, MBA-HCM, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4714 GETTYSBURG RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-4325
Mailing Address - Country:US
Mailing Address - Phone:888-735-6332
Mailing Address - Fax:
Practice Address - Street 1:4714 GETTYSBURG RD
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-4325
Practice Address - Country:US
Practice Address - Phone:888-735-6332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-30
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT022974225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist