Healthcare Provider Details

I. General information

NPI: 1093963621
Provider Name (Legal Business Name): CHRISTOPHER S LYBARGER PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2008
Last Update Date: 01/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7960 E THOMPSON PEAK PKWY SUITE 101
SCOTTSDALE AZ
85255-7406
US

IV. Provider business mailing address

2005 ROUTE 70 E SUITE 101
CHERRY HILL NJ
08003-1279
US

V. Phone/Fax

Practice location:
  • Phone: 480-585-6810
  • Fax: 480-585-6910
Mailing address:
  • Phone: 480-585-6810
  • Fax: 480-585-6910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number8198
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: