Healthcare Provider Details

I. General information

NPI: 1144835174
Provider Name (Legal Business Name): CHRIS KUHN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2020
Last Update Date: 09/15/2020
Certification Date: 09/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E JACKSON ST
PENSACOLA FL
32501-4003
US

IV. Provider business mailing address

1414 WISTERIA AVE
PENSACOLA FL
32507-2253
US

V. Phone/Fax

Practice location:
  • Phone: 850-684-0188
  • Fax:
Mailing address:
  • Phone: 850-292-3981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA78453
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: