MEDICARE: MR. CHRISTOPHER L BRATCHER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies		OK

General Provider Information

NPI Number	:	1295971976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRISTOPHER L BRATCHER

Provider Business Mailing Address
First Line	:	1911 SPIRIT WOOD LN
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73025-1715
Country	:	US
Telephone Number	:	405-314-3058
Fax Number	:	405-562-1975

Provider Business Practice Location Address
First Line	:	1911 SPIRIT WOOD LN
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73025-1715
Country	:	US
Telephone Number	:	405-314-3058
Fax Number	:	405-562-1975

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2008
Last Update Date	:	05/20/2009

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