Provider Demographics
NPI:1912088865
Name:JORGENSEN, CHRISTOPHER DONALD (ATC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:DONALD
Last Name:JORGENSEN
Suffix:
Gender:M
Credentials:ATC
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Mailing Address - Street 1:3 GLENWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:ALDAN
Mailing Address - State:PA
Mailing Address - Zip Code:19018-3113
Mailing Address - Country:US
Mailing Address - Phone:610-570-7581
Mailing Address - Fax:
Practice Address - Street 1:1098 W BALTIMORE PIKE
Practice Address - Street 2:OUTPATIENT PHYSICAL THERAPY
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5139
Practice Address - Country:US
Practice Address - Phone:610-891-3030
Practice Address - Fax:610-891-3035
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2022-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PART0033132255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer