Healthcare Provider Details

I. General information

NPI: 1598819807
Provider Name (Legal Business Name): CHRISTOPHER C MYERS M.S., ATC, CFO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 10/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 NORTH ST CAPE COD ORTHOPAEDICS & SPORTS MEDICINE
HYANNIS MA
02601-3825
US

IV. Provider business mailing address

130 NORTH ST CAPE COD ORTHOPAEDICS & SPORTS MEDICINE
HYANNIS MA
02601-3825
US

V. Phone/Fax

Practice location:
  • Phone: 508-775-8282
  • Fax: 508-771-1496
Mailing address:
  • Phone: 508-775-8282
  • Fax: 508-771-1496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License NumberCFO03229
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number1813
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: