Provider Demographics
NPI:1003666058
Name:CHRISTOPHER DAVIS PHYSICAL THERAPY SERVICES INC
Entity type:Organization
Organization Name:CHRISTOPHER DAVIS PHYSICAL THERAPY SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:337-258-9962
Mailing Address - Street 1:1206 E BROUSSARD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-7835
Mailing Address - Country:US
Mailing Address - Phone:337-450-9111
Mailing Address - Fax:337-484-3164
Practice Address - Street 1:1206 E BROUSSARD RD STE 100
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-7835
Practice Address - Country:US
Practice Address - Phone:337-450-9111
Practice Address - Fax:337-484-3164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty