MEDICARE: MR. CHRISTOPHER RYAN HUNT PT

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	225100000X	Physical Therapist	1156058	TX

General Provider Information

NPI Number	:	1336109594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRISTOPHER RYAN HUNT PT

Provider Business Mailing Address
First Line	:	1105 W 1ST ST
Second Line	:
City	:	GRANDFIELD
State	:	OK
Zip	:	73546-9644
Country	:	US
Telephone Number	:	580-479-3410
Fax Number	:

Provider Business Practice Location Address
First Line	:	302 LOOP 11
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76306-3705
Country	:	US
Telephone Number	:	940-397-8268
Fax Number	:

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

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	07/08/2007

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