Healthcare Provider Details

I. General information

NPI: 1477691582
Provider Name (Legal Business Name): CHRISTOPHER MICHAEL CARRIER PA ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 PETERS RD STE 200
LITITZ PA
17543-7685
US

IV. Provider business mailing address

51 PETERS RD
LITITZ PA
17543-7685
US

V. Phone/Fax

Practice location:
  • Phone: 717-627-7675
  • Fax:
Mailing address:
  • Phone: 717-627-7675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number001196
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC5-000679
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC03530
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA057347
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: