Provider Demographics
NPI:1750581336
Name:DE LEON, CHRISTOPHER VALDOZ (PT)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:VALDOZ
Last Name:DE LEON
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 1:1900 LONA AVE
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:OK
Mailing Address - Zip Code:74868-2053
Mailing Address - Country:US
Mailing Address - Phone:405-343-2391
Mailing Address - Fax:405-382-5433
Practice Address - Street 1:1900 LONA AVE
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:OK
Practice Address - Zip Code:74868-2053
Practice Address - Country:US
Practice Address - Phone:405-343-2391
Practice Address - Fax:405-382-5433
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3147225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist