Healthcare Provider Details

I. General information

NPI: 1609902873
Provider Name (Legal Business Name): CHRISTOPHER FERRY ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 W STEWART DR
ORANGE CA
92868-3849
US

IV. Provider business mailing address

3340 E COLLINS AVE APT 27
ORANGE CA
92867-7598
US

V. Phone/Fax

Practice location:
  • Phone: 714-771-8000
  • Fax:
Mailing address:
  • Phone: 714-923-9294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: