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General NPI Number Information
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NPI Number | 1245561356
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Entity Type | Individual
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Provider Name | CHRISTOPHER D RUNKLE PT
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Gender | Male
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Dates
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Enumeration Date | 01/29/2010
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Last Update Date | 08/19/2022
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Provider Practice Location Address
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Address Line | 1099 DUVAL ST STE 120
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City | LEXINGTON
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State | KY
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Zip | 40515-6489
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Country | US
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Telephone | 859-639-0090
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Fax |
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Provider Business Mailing Address
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Address Line | 5200 COMMERCE CROSSINGS DR FL 3
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City | LOUISVILLE
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State | KY
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Zip | 40229-2182
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Country | US
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Telephone | 502-861-5278
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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 | 007407
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License Number State | KY
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