Provider Demographics
NPI:1205121076
Name:O'CONNOR, CHRISTOPHER ROBERT (DPT)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ROBERT
Last Name:O'CONNOR
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 1:20310 WILCHER CT
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-6844
Mailing Address - Country:US
Mailing Address - Phone:919-260-7481
Mailing Address - Fax:
Practice Address - Street 1:460 S MAIN ST STE 302
Practice Address - Street 2:
Practice Address - City:DAVIDSON
Practice Address - State:NC
Practice Address - Zip Code:28036-8006
Practice Address - Country:US
Practice Address - Phone:919-260-7481
Practice Address - Fax:719-473-1004
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11190225100000X
NCP16166225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist