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General NPI Number Information
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NPI Number | 1023509536
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Entity Type | Individual
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Provider Name | CHRISTOPHER GREGOIRE MS, ATC
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Gender | Male
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Dates
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Enumeration Date | 05/21/2018
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Last Update Date | 05/02/2022
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Provider Practice Location Address
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Address Line | 10567 ZIBIBBA WAY
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City | RANCHO CORDOVA
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State | CA
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Zip | 95670-3826
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Country | US
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Telephone | 916-524-6176
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Fax |
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Provider Business Mailing Address
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Address Line | 10567 ZIBIBBA WAY
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City | RANCHO CORDOVA
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State | CA
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Zip | 95670-3826
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Country | US
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Telephone | 916-524-6176
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2000018598
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT883
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License Number State | ME
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