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NPI 1154801132

NPI 1154801132 : CHRISTOPHER ANTHONY PHILLIPS MSPT, RPT, CSCS : HUNTSVILLE, AL

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General NPI Number Information
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    NPI Number           |    1154801132
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    Entity Type          |    Individual 
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    Provider Name        |    CHRISTOPHER ANTHONY PHILLIPS MSPT, RPT, CSCS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/18/2018
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    Last Update Date     |    03/10/2020
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Provider Practice Location Address
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    Address Line         |    4902 OAKWOOD RD NW 
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    City                 |    HUNTSVILLE
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    State                |    AL
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    Zip                  |    35806-1615
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    Country              |    US
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    Telephone            |    256-508-6528
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4902 OAKWOOD RD NW 
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    City                 |    HUNTSVILLE
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    State                |    AL
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    Zip                  |    35806-1615
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    Country              |    US
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    Telephone            |    256-508-6528
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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        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    PT0000007516
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    License Number State |    TN
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Taxonomy #2
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    PT31843
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    License Number State |    FL
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Taxonomy #3
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    PTH3158
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    License Number State |    AL
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