Healthcare Provider Details

I. General information

NPI: 1699408856
Provider Name (Legal Business Name): CHRISTOPHER POLLOCK PRSS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2022
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2910 EMERSON AVE
PARKERSBURG WV
26104-2519
US

IV. Provider business mailing address

11 GRAHAM DR
ATHENS OH
45701-1430
US

V. Phone/Fax

Practice location:
  • Phone: 740-856-1084
  • Fax:
Mailing address:
  • Phone: 800-321-8293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: