Provider Demographics
NPI:1336549229
Name:LAPRAY, CHRISTOPHER R (DPT, ATC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:R
Last Name:LAPRAY
Suffix:
Gender:M
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1280 CHANDLER DR
Mailing Address - Street 2:
Mailing Address - City:SPOONER
Mailing Address - State:WI
Mailing Address - Zip Code:54801-2202
Mailing Address - Country:US
Mailing Address - Phone:715-939-1745
Mailing Address - Fax:715-939-1557
Practice Address - Street 1:12226 S 1000 E STE 1
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-3205
Practice Address - Country:US
Practice Address - Phone:801-523-3415
Practice Address - Fax:801-523-1843
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-27
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12948-24225100000X
UT8887515-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist