Provider Demographics
NPI:1013778646
Name:MCKINLEY, CHRISTOPHER DANIEL
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:DANIEL
Last Name:MCKINLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2825 TALLAHATTA SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36784-7042
Mailing Address - Country:US
Mailing Address - Phone:334-830-0714
Mailing Address - Fax:
Practice Address - Street 1:2825 TALLAHATTA SPRINGS RD
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:AL
Practice Address - Zip Code:36784-7042
Practice Address - Country:US
Practice Address - Phone:334-830-0714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer