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General NPI Number Information
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NPI Number | 1174190540
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Entity Type | Individual
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Provider Name | CHRISTOPHER DAVID RETTIG PT,DPT
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Gender | Male
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Dates
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Enumeration Date | 06/05/2021
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Last Update Date | 06/05/2021
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Provider Practice Location Address
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Address Line | 3757 CARMAN RD STE 201
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City | SCHENECTADY
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State | NY
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Zip | 12303-5442
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Country | US
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Telephone | 518-356-3139
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Fax |
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Provider Business Mailing Address
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Address Line | 5 TAMARACK LN
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City | SCHENECTADY
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State | NY
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Zip | 12309-1803
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Country | US
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Telephone | 518-727-4565
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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 | 046196
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License Number State | NY
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