Provider Demographics
NPI:1134994759
Name:FORNO, CHRISTIAN (DPT)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:
Last Name:FORNO
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 1:301 CHESTNUT ST APT 1807
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17101-2797
Mailing Address - Country:US
Mailing Address - Phone:717-802-0108
Mailing Address - Fax:
Practice Address - Street 1:175 LANCASTER BLVD
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-3562
Practice Address - Country:US
Practice Address - Phone:717-802-0108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-24
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT025221225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist