MEDICARE: CHRISTOPHER HARTMAN LAT, ATC

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	246Z00000X	Other Specialist/Technologist	A000031	MD

General Provider Information

NPI Number	:	1407391311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER HARTMAN LAT, ATC

Provider Business Mailing Address
First Line	:	2 WILSON AVE
Second Line	:	PO BOX 78
City	:	RISING SUN
State	:	MD
Zip	:	21911-2168
Country	:	US
Telephone Number	:	410-688-2563
Fax Number	:

Provider Business Practice Location Address
First Line	:	2755 AUGUSTINE HERMAN HWY
Second Line	:
City	:	CHESAPEAKE CITY
State	:	MD
Zip	:	21915-1408
Country	:	US
Telephone Number	:	410-885-2075
Fax Number	:

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

Provider Enumeration Date	:	12/31/2016
Last Update Date	:	12/31/2016

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