Healthcare Provider Details

I. General information

NPI: 1164847620
Provider Name (Legal Business Name): CHRISTOPHER HALE CRT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2014
Last Update Date: 02/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

247 W FIRST AVE
ELKINS AR
72727-3519
US

IV. Provider business mailing address

247 W FIRST AVE
ELKINS AR
72727-3519
US

V. Phone/Fax

Practice location:
  • Phone: 479-225-6883
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License NumberRCP-3411
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2278E0002X
TaxonomyEmergency Care Certified Respiratory Therapist
License NumberRCP-3411
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: