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General NPI Number Information
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NPI Number | 1598321374
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Entity Type | Individual
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Provider Name | CHRISTIAN WADE DPT
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Gender | Male
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Dates
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Enumeration Date | 05/16/2019
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Last Update Date | 06/01/2023
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Provider Practice Location Address
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Address Line | 5818 N NEVADA AVE STE 325
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-3505
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Country | US
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Telephone | 719-365-6871
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Fax |
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Provider Business Mailing Address
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Address Line | 5818 N NEVADA AVE STE 325
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-3505
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Country | US
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Telephone | 719-365-6871
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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 |
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License Number State |
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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 | 1322363
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License Number State | TX
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