Provider Demographics
NPI:1740901818
Name:GREAVES, CHRISTOPHER WARREN (DPT)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:WARREN
Last Name:GREAVES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 S GREENFIELD RD APT 2033
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-2183
Mailing Address - Country:US
Mailing Address - Phone:480-673-8781
Mailing Address - Fax:
Practice Address - Street 1:10861 E BASELINE RD STE A-105
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-7921
Practice Address - Country:US
Practice Address - Phone:520-231-1360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ31884225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist