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General NPI Number Information
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NPI Number | 1407405921
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Entity Type | Individual
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Provider Name | CHRISTOPHER DAVID THOMAS BA
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Gender | Male
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Dates
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Enumeration Date | 09/06/2019
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Last Update Date | 09/06/2019
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Provider Practice Location Address
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Address Line | 120 N DUKE ST
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City | LANCASTER
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State | PA
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Zip | 17602-2825
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Country | US
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Telephone | 717-291-4754
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Fax |
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Provider Business Mailing Address
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Address Line | 226 FAUSNACHT DR
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City | DENVER
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State | PA
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Zip | 17517-1136
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Country | US
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Telephone | 717-413-0528
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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