Provider Demographics
NPI:1134948680
Name:DUKE, CHRISTOPHER (LMT)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:DUKE
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 BIRNAM WOODS DR
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30223-6683
Mailing Address - Country:US
Mailing Address - Phone:470-713-0359
Mailing Address - Fax:
Practice Address - Street 1:14 EASTBROOK BND STE 208
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-1521
Practice Address - Country:US
Practice Address - Phone:470-713-0359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT015025225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist