Provider Demographics
NPI:1336604792
Name:EHRMAN, CHRISTOPHER (MAT, ATC, LMT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:EHRMAN
Suffix:
Gender:M
Credentials:MAT, ATC, LMT
Other - Prefix:
Other - First Name:CHRISTOPHER
Other - Middle Name:
Other - Last Name:EHRMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MAT, ATC, LMT
Mailing Address - Street 1:808 N 31ST ST STE D
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-3942
Mailing Address - Country:US
Mailing Address - Phone:318-548-8594
Mailing Address - Fax:
Practice Address - Street 1:808 N 31ST ST STE D
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-3942
Practice Address - Country:US
Practice Address - Phone:318-548-8594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-09
Last Update Date:2019-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA7504225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty