Healthcare Provider Details

I. General information

NPI: 1750389722
Provider Name (Legal Business Name): CHRISTOPHER ARMSTRONG LEVAN PT,MS, OCS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

279 EGG HARBOR RD SUITE C-1
SEWELL NJ
08080-3149
US

IV. Provider business mailing address

279 EGG HARBOR RD SUITE C-1
SEWELL NJ
08080-3149
US

V. Phone/Fax

Practice location:
  • Phone: 856-256-8393
  • Fax: 856-256-8390
Mailing address:
  • Phone: 856-256-8393
  • Fax: 856-256-8390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number40QA00878000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: