Provider Demographics
NPI:1255984142
Name:WHITMORE, CHRISTOPHER (ATC, PTA)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:WHITMORE
Suffix:
Gender:M
Credentials:ATC, PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2575 S SYRACUSE WAY APT J301
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-3885
Mailing Address - Country:US
Mailing Address - Phone:303-653-4376
Mailing Address - Fax:
Practice Address - Street 1:5801 S QUEBEC ST STE 100
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2010
Practice Address - Country:US
Practice Address - Phone:303-770-0870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-19
Last Update Date:2021-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00138092081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0001592OtherCOLORADO DEPARTMENT OF REGULATORY AGENCIES OFFICE OF ATHLETIC TRAINING
CO0013809OtherCOLORADO DEPARTMENT OF REGULATORY AGENCIES STATE PHYSICAL THERAPY