Provider Demographics
NPI:1972910131
Name:BRECHTEL, CHRISTOPHER WAYDE (PT, GCS, MBA)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:WAYDE
Last Name:BRECHTEL
Suffix:
Gender:M
Credentials:PT, GCS, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3968 SWEET BOTTOM DR
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-3158
Mailing Address - Country:US
Mailing Address - Phone:678-226-9772
Mailing Address - Fax:
Practice Address - Street 1:3968 SWEET BOTTOM DR
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-3158
Practice Address - Country:US
Practice Address - Phone:678-226-9772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-18
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT009237225100000X
FLPT18325225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist