Provider Demographics
NPI:1356978191
Name:MOREHOUSE, CHRISTOPHER W (PTA)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:W
Last Name:MOREHOUSE
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 1:87 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:MA
Mailing Address - Zip Code:01226-1118
Mailing Address - Country:US
Mailing Address - Phone:413-344-5335
Mailing Address - Fax:
Practice Address - Street 1:40 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:LENOX
Practice Address - State:MA
Practice Address - Zip Code:01240-2018
Practice Address - Country:US
Practice Address - Phone:413-637-5011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-23
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9173225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant