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General NPI Number Information
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NPI Number | 1366573933
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Entity Type | Individual
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Provider Name | CHRISTOPHER S BETHARD
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Gender | Male
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 03/09/2009
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Provider Practice Location Address
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Address Line | 1288 S GOVERNORS AVE
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City | DOVER
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State | DE
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Zip | 19904-4802
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Country | US
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Telephone | 302-677-0100
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Fax | 302-677-0267
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Provider Business Mailing Address
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Address Line | 1812 MARSH RD STORE 505
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City | WILMINGTON
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State | DE
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Zip | 19810-4581
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Country | US
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Telephone | 302-793-1800
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Fax | 302-793-0800
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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 | J1-0000933
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | J3-0000066
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | JI-0000933
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License Number State | DE
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