Provider Demographics
NPI:1881009272
Name:O'BRIEN, CHRISTOPHER MICHAEL (DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:MICHAEL
Last Name:O'BRIEN
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 1:1113 N CASTLE HEIGHTS AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-5640
Mailing Address - Country:US
Mailing Address - Phone:615-965-9000
Mailing Address - Fax:615-965-9001
Practice Address - Street 1:1113 N CASTLE HEIGHTS AVE
Practice Address - Street 2:SUITE D
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-5640
Practice Address - Country:US
Practice Address - Phone:615-965-9000
Practice Address - Fax:615-965-9001
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10042225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist