Healthcare Provider Details

I. General information

NPI: 1083186282
Provider Name (Legal Business Name): CHRISTOPHER GEDDINGS LMBT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2018
Last Update Date: 12/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

816 BROAD ST
DURHAM NC
27705-4148
US

IV. Provider business mailing address

2065 ELAM CURRIN RD
OXFORD NC
27565-8421
US

V. Phone/Fax

Practice location:
  • Phone: 919-360-7758
  • Fax:
Mailing address:
  • Phone: 919-360-7758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number17381
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: