MEDICARE: MR. CHRIS K. ROYER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	385HR2055X	Child Mental Illness Respite Care	2358863	AZ

General Provider Information

NPI Number	:	1699078212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRIS K. ROYER

Provider Business Mailing Address
First Line	:	2388 E SPRING PIONEER LN
Second Line	:
City	:	ORO VALLEY
State	:	AZ
Zip	:	85755-1929
Country	:	US
Telephone Number	:	520-797-1610
Fax Number	:

Provider Business Practice Location Address
First Line	:	2388 E SPRING PIONEER LN
Second Line	:
City	:	ORO VALLEY
State	:	AZ
Zip	:	85755-1929
Country	:	US
Telephone Number	:	520-797-1610
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2010
Last Update Date	:	12/21/2010

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