Provider Demographics
NPI:1356525844
Name:DOCKERY, CHRIS (PTA)
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:DOCKERY
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 SMITH RD
Mailing Address - Street 2:
Mailing Address - City:PARRISH
Mailing Address - State:AL
Mailing Address - Zip Code:35580-5326
Mailing Address - Country:US
Mailing Address - Phone:205-388-6350
Mailing Address - Fax:
Practice Address - Street 1:3101 10TH ST
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76309-2103
Practice Address - Country:US
Practice Address - Phone:940-766-0281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant