Provider Demographics
NPI:1295728947
Name:MARCUS, CHRISTOPHER JAMES (ATC, SCAT)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JAMES
Last Name:MARCUS
Suffix:
Gender:M
Credentials:ATC, SCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4977 MURRAY JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526-4767
Mailing Address - Country:US
Mailing Address - Phone:843-365-5138
Mailing Address - Fax:843-358-7401
Practice Address - Street 1:201 JORDANVILLE RD
Practice Address - Street 2:
Practice Address - City:AYNOR
Practice Address - State:SC
Practice Address - Zip Code:29511-3601
Practice Address - Country:US
Practice Address - Phone:843-358-5114
Practice Address - Fax:843-358-7401
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4132255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer