Provider Demographics
NPI:1720111263
Name:BERCHEM, CHRISTOPHER PETER (PT)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:PETER
Last Name:BERCHEM
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8811 92ND ST S STE 101
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55016-4037
Mailing Address - Country:US
Mailing Address - Phone:651-241-3777
Mailing Address - Fax:651-241-3778
Practice Address - Street 1:8811 92ND ST S
Practice Address - Street 2:SUITE 101
Practice Address - City:COTTAGE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55016-4036
Practice Address - Country:US
Practice Address - Phone:651-458-9446
Practice Address - Fax:651-458-0817
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN42862251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic