Healthcare Provider Details

I. General information

NPI: 1801524566
Provider Name (Legal Business Name): CHRISTOPHER EDWARDS OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2022
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5006 COPPER AVE NE
ALBUQUERQUE NM
87108-1301
US

IV. Provider business mailing address

5006 COPPER AVE NE
ALBUQUERQUE NM
87108-1301
US

V. Phone/Fax

Practice location:
  • Phone: 505-268-7988
  • Fax: 505-268-8021
Mailing address:
  • Phone: 505-268-7988
  • Fax: 505-268-8021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT-2026-0113
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: